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Kenneth Warren Price, Maria Ana Martinez-Castellanos, Robison Vernon Paul Chan; Screening criteria for Retinopathy of Prematurity in Mexico, a Middle-income Country. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):956.
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Retinopathy of prematurity (ROP) is a leading cause of childhood blindness around the world and is potentially avoidable. The incidence of ROP varies between countries based on their development due to a variety of factors. The aim of this study is to analyze the effectiveness of current screening criteria in Mexico.
The clinical records of 165 outpatients from a tertiary ophthalmology center in Mexico City were retrospectively analyzed to identify infants with ROP diagnosis between October 2011 and March 2014. Physical characteristics, emphasizing weight and gestational age, were noted. Special attention was paid to infants that were treated for ROP and did not fall within the screening criteria set forth by the American Academy of Ophthalmology (AAO) or the American Academy of Pediatrics (AAP), namely general screening for infants with a gestational age of less than or equal to 30 weeks or birth weight less than or equal to 1500 grams. Select infants are also recommended for screening with a birth weight between 1500-2000 grams or gestational age of > 30 weeks with an unstable clinical course.
137 infants were diagnosed with ROP; 33 (24%) weighed > 1500 g at birth (range 1501-2910g), and 80 (58%) were born at > 30 weeks of gestation (range 31-38 wks). The mean birth weight for all infants in this study diagnosed with ROP was 1268 ± 374 grams. The mean gestational age was 30.3 ± 2.4 weeks. Using the AAO/AAP guidelines and excluding infants with a history of a clinical course, 22 infants (16%) in our study group would have gone undiagnosed. Of these 22, 14 had prethreshold or type 2 ROP while 8 went on to develop threshold ROP, 5 of which required intensive intervention.
The Mexican Ministry of Health released screening suggestions in 2010 that followed the 2008 AAO/AAP recommendations closely. The findings shown here illustrate how the current screening criteria is based on a different population and is not sufficient to detect all cases of ROP in Mexico. Examination and alteration of the current screening guidelines for Mexico should be considered to include all babies at risk for ROP. Our recommendations include increasing the screening criteria to include babies with GA < 34 weeks and BW < 2000g independent of any other diagnosis.
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