Examining Guidelines for Late Follow-up of Non-treatment-Requiring Retinopathy of Prematurity

To investigate the incidence of visual complications in low-risk, non-treatment-requiring infants following retinopathy of prematurity (ROP) screening and determine whether workforce constraints in pediatric ophthalmology and limited resources affect compliance with current guidelines advising 4- to 6-month ophthalmic follow-up for all infants with ROP.

This retrospective case-control study included premature infants with resolved non-treatment- requiring ROP (NT-ROP) evaluated 6 to 12 months after screening and full-term infants younger than 19 months referred for ophthalmologic evaluation following failed routine vision screening. Data were collected over a 14-month period in a private practice setting. Refractive and ophthalmic outcomes were compared between groups. Outcomes included manifest strabismus in primary gaze and visually significant refractive error: myopia (>3.00 diopters [D]), hyperopia (>4.00 D), astigmatism (>3.00 cylinder), or anisometropia (>1.25 D difference).

Sixty-three infants with NT-ROP and 39 full-term infants referred after failed routine pediatric vision screening were included. Incidence of late visual complications was low in both groups, with no significant difference observed between groups on follow-up. (P > .05).

Infants with resolved NT-ROP did not exhibit a greater incidence of late visual complications compared to full-term infants with failed routine vision screening. These preliminary findings will require validation with larger cohorts, but suggest that for infants with mild, non-treatment-requiring ROP, routine pediatric photoscreening 4 to 6 months after ROP screening may suffice as an alternative to full cycloplegic dilated examination. This approach could improve resource allocation without compromising surveillance. Study limitations include its retrospective, single-center design and small sample size. Larger, multi-center studies are needed to validate these findings.