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Published on: March 26, 2020
Towards a universal approach for screening of retinopathy of prematurity (ROP)
N E Schalij-Delfos1, B L Zijllmans, B P Cats
1F.C. Donders Institute of Ophthalmology, University Hospital, Utrecht, The Netherlands.
Insights
This study suggests a new screening strategy for retinopathy of prematurity (ROP) using a safety index. This approach could reduce eye examinations while minimizing the risk of missing non-vision threatening ROP cases.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current screening protocols for ROP aim to detect the condition early but can be resource-intensive.
- Optimizing the cost-benefit ratio of ROP screening is crucial for widespread implementation.
Purpose of the Study:
- To evaluate a novel ROP screening strategy based on a safety index.
- To determine the potential reduction in ophthalmological examinations.
- To assess the impact on the detection rate of non-vision threatening ROP.
Main Methods:
- Retrospective analysis of 312 infants screened for ROP.
- Development and application of a safety index using birthweight, gestational age, and oxygen use.
- Classification of infants into high-risk and low-risk groups for ROP development.
Main Results:
- A proposed screening protocol involves extensive screening for high-risk infants from the 5th postnatal week and a single screening for low-risk infants at the 7th postnatal week.
- This strategy could lead to a 9.8% reduction in ophthalmological examinations.
- A trade-off of missing 2.9% of non-vision threatening ROP cases was observed.
Conclusions:
- The proposed safety index-based ROP screening strategy offers a potential improvement in cost-benefit efficiency.
- This targeted approach may allow for a more optimized allocation of healthcare resources in ROP screening programs.
- Further prospective studies are warranted to validate these findings in clinical practice.
Abstract:
To improve the cost-benefit ratio of our current screening program for retinopathy of prematurity (ROP), the records of 312 infants who had been screened for ROP were studied retrospectively. Using a safety-index containing three well known risk factors (birthweight, gestational age, oxygen use), infants were classified to be at high risk or low risk for the development of ROP. When all high risk infants would have been screened extensively from the 5th postnatal week onwards and all low risk infants would have been screened once at the 7th postnatal week, a 9.8% reduction of ophthalmological examinations would have been obtained at the expense of missing 2.9% of non vision threatening ROP.
