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Published on: February 18, 2012
Optimal timing of retina examinations for premature infants
H J Chen1, R J Teng, K I Tsou Yau
1Department of Pediatrics, Provincial Tao-Yuan Hospital, Taiwan.
Insights
Optimal timing for retinopathy of prematurity (ROP) screening in premature infants is best determined by postconceptional age. This study suggests using postconceptional age, not postnatal age, for ROP retinal examinations.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Perinatology
Background:
- Neonatal intensive care advances have increased survival rates for very premature infants.
- This has led to a rise in retinopathy of prematurity (ROP) cases.
- ROP is a significant cause of vision impairment in premature infants.
Purpose of the Study:
- To investigate the relationship between ROP severity and its timeline.
- To determine the optimal timing for ROP retinal examinations in premature infants.
- To analyze ROP onset based on infant birth weight and gestational age.
Main Methods:
- Retrospective analysis of 80 premature infants diagnosed with ROP.
- Data collected included postnatal age, postconceptional age, birth weight, and gestational age.
- ROP stages were recorded, from stage 1 to stage 4, including threshold disease.
Main Results:
- Mean postnatal diagnosis ages ranged from 7.3 weeks (stage 1) to 11.7 weeks (stage 4).
- Mean postconceptional diagnosis ages ranged from 35 weeks (stage 1) to 40 weeks (stage 4).
- Initial ROP detection occurred around 36 weeks postconceptional age for the entire cohort, irrespective of birth weight or gestational age.
Conclusions:
- Postconceptional age is a more reliable indicator for ROP screening timing than postnatal age.
- Routine retinal examinations for premature infants should be scheduled based on postconceptional age.
- This approach can help optimize ROP detection and management in vulnerable infants.
Abstract:
Developments in modern neonatal intensive care have resulted in increased survival of very premature infants. Along with this increase in survival, there has been a concomitant increase in the frequency of retinopathy of prematurity (ROP). We investigated the relationship between the severity and the time course of ROP as well as the optimal time for retinal examinations of premature infants of various birth weights and gestational ages. A total of 80 premature infants were enrolled for analysis. The mean postnatal age of infants at the time of diagnosis was 7.3 +/- 3.4 weeks for stage 1 retinopathy, 9.2 +/- 5.8 for stage 2 retinopathy, 9.5 +/- 3.8 for stage 3 retinopathy, 10.7 +/- 3.7 for threshold disease, and 11.7 +/- 3.2 for stage 4 retinopathy. The mean postconceptional age of infants at the time of diagnosis was 35 +/- 3 for stage 1 retinopathy, 36.4 +/- 3 for stage 2 retinopathy, 37.6 +/- 3.5 for stage 3 retinopathy, 38.4 +/- 3.5 for threshold disease, and 40 +/- 3.7 for stage 4 retinopathy. The age at the time of the initial detection of ROP was from the ninth to 10th week among infants weighing less than 1,000 g at birth and from the fifth to seventh week among those weighing 1,000 g or more at birth. However, the postconceptional age at the time of initial detection of ROP for the whole group was 36 weeks and was not influenced by birth weight or gestational age. Therefore, we suggest that postconceptional age, rather than postnatal age, should be used to decide the timing of retinal examinations for premature infants.
