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[Multicenter prospective study of retinopathy of prematurity--II. Optimum timing of the first examination]
A Takeuchi1, M Nagata, H Terauchi
1Eye Clinic, Tenri Hospital, Japan.
Insights
The optimal time for the first eye exam for retinopathy of prematurity (ROP) is 3 weeks after birth or by 29 weeks postconception. Early screening ensures timely treatment for severe ROP.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Early detection and treatment of ROP are crucial to prevent severe visual outcomes.
Purpose of the Study:
- To determine the optimal timing for the initial ophthalmological examination in infants at risk for retinopathy of prematurity.
- To establish screening guidelines based on ROP onset, treatment timing, and fundus visibility.
Main Methods:
- Retrospective review of 360 retinopathy of prematurity cases across 12 Japanese institutions.
- Analysis of ROP onset, treatment initiation, and fundus visibility relative to postconceptional age.
Main Results:
- The recommended latest timing for the first ophthalmological examination is 3 weeks after birth or 29 weeks postconception.
- Fundus visibility is generally adequate by 29 weeks postconception, with minimal hazy media.
- For infants born before 26 weeks of gestation, funduscopy at 29 weeks postconception is advised.
Conclusions:
- The optimal timing for the first ROP screening is 3 weeks after birth, or no later than 29 weeks postconception.
- This timing allows for timely detection and management of sight-threatening ROP, particularly "plus" disease.
- Screening at 29 weeks postconception is particularly important for extremely premature infants (born < 26 weeks gestation).
Abstract:
We reviewed the records of 360 cases of retinopathy of prematurity (ROP) in 12 institutions in Japan, and investigated the optimum timing of the first examination. On the basis of the onset of ROP and the timing of the first treatment, the first ophthalmological examination should be performed 3 weeks after birth or 29 weeks of postconceptional age at the latest. Regarding the visibility of the fundus, there was little hazy media after 29 weeks of postconceptional age. Under the basic policy that the severe progressive "plus" disease should be properly treated, we concluded that the first ophthalmological examination should be performed 3 weeks after birth at the latest. When the gestational age at birth is less than 26 weeks, funduscopy at the post conceptional age of 29 weeks is advisable.