Related Experiment Video
Updated: Jul 3, 2026
Assessment of Vascular Regeneration in the CNS Using the Mouse Retina
Published on: June 23, 2014
Systematic review of the guidelines for retinopathy of prematurity
Michał Kościółek1,2,3, Weronika Kisielewska3,4, Marlena Ćwiklik-Wierzbowska5
149805University Clinical Center of the Medical University of Warsaw Central Clinical Hospital, Warsaw, Poland.
Insights
Retinopathy of prematurity (ROP) screening guidelines vary globally due to differences in neonatal care quality. This review compared ROP guidelines, highlighting variations in screening criteria, especially for resource-poor settings.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in preterm infants.
- Variations in neonatal care quality necessitate tailored ROP screening protocols.
- Universal ROP screening criteria are challenging due to diverse infant characteristics.
Purpose of the Study:
- To compare existing national and international Retinopathy of Prematurity (ROP) screening guidelines.
- To inform the development of ROP guidelines, particularly for resource-limited settings.
Main Methods:
- Systematic review of PubMed, Embase, and guideline registers (2010-2021).
- Inclusion of 23 national or international policy statements and guidelines.
- Review of bibliographies from relevant publications.
Main Results:
- Most guidelines used gestational age (<32 weeks) or birth weight (<1500g) for screening cut-offs.
- Higher cut-offs were observed in the Philippines (<35 weeks GA; <2000g) and India (<34 weeks GA; <2000g).
- Lower cut-offs were found in high-income countries like the USA (≤32 weeks GA) and New Zealand (<1250g BW).
- Consensus existed on treatment indications, timing, and methods, but anti-VEGF therapy indications varied.
- Guidelines were scarce for low-income countries, and screening variations reflected differing risk factor exposures.
Conclusions:
- Significant variation exists in ROP screening guidelines globally.
- Guidelines often incorporate additional risk factors beyond gestational age and birth weight.
- Further development of ROP guidelines is needed, especially for resource-poor settings, to address local risk factors and care quality.
Abstract:
As the characteristics of preterm infants with retinopathy of prematurity (ROP) vary, depending on the quality of neonatal care they received, universal screening criteria for ROP are not possible. The purpose of this study was to compare ROP guidelines for those planning to develop guidelines, particularly in resource-poor settings.A systematic review was undertaken of PubMed, Embase and guidelines registers to identify national or international policy statements or guidelines in English, issued or operational in 2010-2021. Bibliographies of two publications were also reviewed. The searches identified 633, 1081 and 317 records, respectively, and 157 records were retrieved from other sources. 23 publications were included in the analysis.Most included documents defined cut-offs for screening as <32 weeks gestational age (GA) or ≤1500g birth weight (BW). The highest values were in the Philippines (<35 weeks GA; <2000g) and India (≤34 weeks GA; <2000g). The lowest were in high-income countries, i.e. the United States of America (≤32 weeks for GA) and New Zealand (<1250g for BW). Most guidelines included additional risk factors to consider. The most frequent indication for when screening should start was a combination of GA and chronological age. All but one document defined when screening could stop. There was general consensus on the indications, timing and methods of treatment. Indications for anti-VEGF therapy varied between countries.Guidelines were identified for a limited number of countries with none from low-income settings. Variation in the indications for screening reflects the varying exposure to risk factors in different settings.
