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[Retinopathy of prematurity. Experiences with a routine examination]
T Flage1, P H Finne, A Whitelaw
1Oyeavdelingen, Rikshospitalet, Oslo.
Insights
Routine screening for retinopathy of prematurity (ROP) is recommended for premature infants under 31 weeks gestational age or 1,500 g birth weight. Early ophthalmological exams can identify ROP requiring cryotherapy.
Area of Science:
- Neonatal Ophthalmology
- Perinatal Medicine
Context:
- Retinopathy of prematurity (ROP) is a leading cause of childhood visual impairment and blindness.
- Effective screening protocols are crucial for early detection and intervention.
Purpose:
- To evaluate the efficacy of a previously proposed ophthalmoscopic examination schedule for identifying ROP in high-risk infants.
- To assess the incidence of ROP and the need for cryotherapy within the study cohort.
Summary:
- A schedule for ROP screening was applied to 103 infants with gestational age <31 weeks and/or birth weight <1,500 g.
- Retinopathy was detected in 27 infants; six developed stage 3 "plus" disease, with five requiring cryotherapy.
- Infants with gestational age >26 weeks or birth weight >1,000 g did not develop stage 3 "plus" ROP.
Impact:
- The study supports continued routine ROP screening for preterm infants based on gestational age and birth weight criteria.
- Recommendations include initiating ophthalmological examinations at 5-6 weeks postnatal age for early ROP detection.
Abstract:
Retinopathy of prematurity continues to be an important cause of serious visual impairment and blindness in children. We have previously suggested a schedule for ophthalmoscopic examinations to identify the serious cases where there may be indication for cryotherapy. We present our experience from this schedule, which covered premature infants with gestational age below 31 weeks and/or birth weight below 1,500 g. 103 infants in two neonatal intensive care units were monitored according to our schedule. Mean gestational age was 27.4 weeks (23 to 33 weeks). Mean birth weight was 995 g (530 to 1,650 g). Retinopathy was found in 27 infants. Six developed stage 3 "plus" disease and five of these had an indication for cryotherapy. No infant with gestational age over 26 weeks or birth weight over 1,000 g had stage 3 "plus" disease. The incidence of retinopathy in our series was low by international standards. We recommend that routine screening for retinopathy should continue in the above gestational age and birth weight groups. Ophthalmological examinations must begin at 5 to 6 weeks postnatal age.