Retinopathy of Prematurity: Are We Screening Babies Efficiently?

Abstract

Abstract: : Purpose: : To find out whether birthweight (BW) <1251 grams and gestational age (GA) equal to / or <30 weeks could provide a safe and efficient means of detecting treatable ROP. Methods: Infants either with a birth weight below 1500 g or a gestational age of less than or equal to 32 weeks were screened for ROP during a one–year period by a single examiner at the Royal Hospital for Sick Children. Results: An incidence of 52/174 (30%) ROP was noted. The maximum stage reached was stage 1 in 17 (9.7%), stage 2 in 8 (4.5%), stage 3 in 10 (5.7%) babies and stage 4 in 3/174(1.7%) babies. Threshold ROP was present in 17/174 (9.7%) babies. Significantly fewer babies 155/174 (89%) would have been examined had a birth weight of <1251 grams or a gestational age < or equal to 30 weeks been applied. There were 71/174 (40.8%) babies with birth weight >1250 grams and 25/174 (14.3%) babies with a gestational age >30 weeks. All babies with ROP with birth weight greater than 1250 grams and gestational age >30 weeks were either stage 1 or stage 2. All babies with stage 3 or threshold ROP had a birth weight <1000 grams and gestational age < 28 weeks. Conclusions: Our experience suggests that the ophthalmic examination may be safely and efficiently concentrated in babies with birth weight <1251 grams and gestational age < or = to 30 weeks. In order to focus screening on the vision–threatening stages of ROP there may be a need for further refinement of screening guidelines.

Keywords: retinopathy of prematurity • retina • clinical research methodology