Training of residents and fellows in retinopathy of prematurity (ROP) around the world: an international web-based survey

Abstract

Purpose : As the rate of neonatal survival continues to rise in lower and middle income countries, the number of newborns who are susceptible to developing retinopathy of prematurity (ROP) will increase. Thus, there will be a greater need for ophthalmologists skilled in ROP diagnosis and management. The purpose of this study is to characterize ROP training practices in international residency and fellowship programs.

Methods : The study was granted an exemption by the Institutional Review Board. A publicly available web-based platform (SurveyMonkey) was used to develop a 28 question, multiple-choice survey that focused on evaluation of training for ROP screening and treatment. We solicited training programs in the Philippines, Thailand, Mongolia, Costa Rica and Taiwan. Survey responses were collected from July 2016–February 2017 and analyzed using descriptive statistics.

Results : A total of 101 responses collected from residents, fellows, and attending ophthalmologists from three countries were analyzed. Responses from three countries had adequate participation to be included in the analysis, and results from two countries were excluded due to either no response or incomplete responses. 46 of 96 participants (48%) reported 1-33% of screenings were performed under direct attending supervision, and 35 of 95 participants (37%) reported the use of formal assessments for ROP competency during their training. The majority of respondents (Country A, 88%; Country B, 72%; Country C, 75%) estimated 1-33% of their clinical practice involved ROP screening. Notably, 44 of 96 participants (46%) reported performing zero laser photocoagulation treatments during training (Country A, 63%; Country B, 38%, Country C, 32%).

Conclusions : International ophthalmology trainees perform a limited number of ROP examinations and laser interventions during their training. ROP examinations by trainees are often unsupervised and lead to no formal evaluation by an attending ophthalmologist. Limited ROP training among ophthalmologists may lead to misdiagnosis and patient mismanagement. Loss of vision and/or exposure to unwarranted treatments are among the implications of such errors. Our findings may serve as a foundation to improve ROP curricula and training in international ophthalmology residency and fellowship programs.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Number of ROP examinations performed in the neonatal intensive care unit during training.