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Evaluation and modification of French screening guidelines for retinopathy of prematurity
Amandine Barjol1, Anne Laure Lux2, Pascal Dureau1
1Fondation Ophtalmologique Rothschild, Pediatric Ophthalmology Department, Paris, France.
Insights
French retinopathy of prematurity (ROP) screening guidelines may be improved by adjusting gestational age (GA) and postmenstrual age (PMA) criteria. This could reduce screening for premature infants while maintaining effective detection of ROP needing treatment.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current French screening guidelines for ROP aim to detect the condition early but may warrant optimization.
- Gestational age (GA) and birth weight (BW) are key factors influencing ROP development.
Purpose of the Study:
- To evaluate the efficacy of current French screening guidelines for retinopathy of prematurity (ROP).
- To propose modifications to the existing ROP screening protocols in France.
- To identify optimal gestational age (GA) and postmenstrual age (PMA) for ROP screening.
Main Methods:
- A multicentric retrospective, noncomparative, interventional case series.
- Inclusion of infants with GA ≤32 weeks screened for ROP between 2011 and 2018.
- Analysis of ROP presence and treatment necessity as main outcome measures.
Main Results:
- 2246 infants with a mean GA of 28.9 weeks were screened.
- ROP was detected in 30.4% of infants; 2.6% had type 1 ROP requiring treatment.
- Infants needing treatment had a mean GA of 25.9 weeks and mean BW of 774.1g; none had GA ≥31 weeks or required treatment before 33 weeks PMA or 6 weeks PNA.
Conclusions:
- Current ROP screening guidelines in France may be refined.
- Screening could potentially be reduced to infants with GA ≤31 weeks.
- Suggested screening initiation: 31 weeks PMA for GA <26 weeks, and 6 weeks PNA for more mature infants.
Purpose:
To evaluate the current French screening guidelines for retinopathy of prematurity (ROP) and to suggest modifications to it.
Methods:
In this multicentric retrospective, noncomparative, interventional case series we included infants with a gestational age (GA) ≤32 weeks who were screened for ROP by fundus examination between 2011 and 2018. Main Outcome Measures were the presence of ROP and the need for treatment.
Results:
A total of 2246 children with a mean GA of 28.9 ± 2.0 weeks and mean birth weight (BW) of 1141.1 ± 332.0 g were screened. Retinopathy of prematurity (ROP) was found in 683 infants (30.4%), of whom 145 (6.5%) had type 2 ROP and 58 (2.6%) had type 1 ROP. Mean GA of infants with type 1 ROP needing treatment was 25.9 + 1.5 weeks (range: 23.6-30) and mean BW was 774.1 ± 173.7 g (range: 540-1400). Both GA and BW had an impact on the development of type 1 and 2 ROP. None of the infants needing treatment had a GA of 31 weeks or more. None of the children needed treatment before 33 weeks of postmenstrual age (PMA) or 6 weeks of postnatal age (PNA).
Conclusion:
It seems possible to decrease the screening of premature infants to ≤31 weeks of GA and to start screening at 31 weeks PMA for infants having a GA < 26 weeks and at 6 weeks PNA for more mature children.
