Restricted universal guidelines for ROP screening: A possible misguidance for middle income countries

The objective of all studies evaluating retinopathy of prematurity (ROP) screening criteria has been to minimize the number of infants screened while missing no patients with ROP who required treatment. Studies supporting the recommendation that screening for ROP could be restricted to infants born at less than 30 weeks of gestation with birth weights of less than 1250 g have been reported recently, especially from Western countries. However, with the lack of local outcome data, application of the new restricted screening guidelines to infants in middle income countries may lead to misguidance. We aimed to investigate ROP screening requirements in infants born at more than 30 weeks of gestation with birth weights above 1250 g in our unit and to compare them with different countries’ screening guidelines to assess the possible risk of restricted guidelines in our unit. Materials and methods: Retinopathy screening results were analyzed in relevance to the birth weight, gestational age, and contributing clinical factors. Infants who had a gestational age of 30 weeks or less and a birth weight less than or equal to 1250 g (Group 1) were compared to those who had a gestational age greater than 30 weeks and a birth weight greater than 1250 g (Group 2). Results: Among 226 live premature infants, 51 (22.5%) of them required laser treatment. No patient developed blindness. The majority of patients who required laser treatment (n = 27, 53%) belonged to Group 2. Conclusion: This study showed that applying developed countries’ guidelines might lead to a misdiagnosis of many patients who require treatment. Restriction criteria in retinopathy screening guidelines should be based on local population studies of the disease, not on results from other regions like high income countries.

Restricted universal guidelines for ROP screening: A possible misguidance for middle income countries

The objective of all studies evaluating retinopathy of prematurity (ROP) screening criteria has been to minimize the number of infants screened while missing no patients with ROP who required treatment. Studies supporting the recommendation that screening for ROP could be restricted to infants born at less than 30 weeks of gestation with birth weights of less than 1250 g have been reported recently, especially from Western countries. However, with the lack of local outcome data, application of the new restricted screening guidelines to infants in middle income countries may lead to misguidance. We aimed to investigate ROP screening requirements in infants born at more than 30 weeks of gestation with birth weights above 1250 g in our unit and to compare them with different countries’ screening guidelines to assess the possible risk of restricted guidelines in our unit. Materials and methods: Retinopathy screening results were analyzed in relevance to the birth weight, gestational age, and contributing clinical factors. Infants who had a gestational age of 30 weeks or less and a birth weight less than or equal to 1250 g (Group 1) were compared to those who had a gestational age greater than 30 weeks and a birth weight greater than 1250 g (Group 2). Results: Among 226 live premature infants, 51 (22.5%) of them required laser treatment. No patient developed blindness. The majority of patients who required laser treatment (n = 27, 53%) belonged to Group 2. Conclusion: This study showed that applying developed countries’ guidelines might lead to a misdiagnosis of many patients who require treatment. Restriction criteria in retinopathy screening guidelines should be based on local population studies of the disease, not on results from other regions like high income countries.

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  • Andruscavage L, Weissgold DJ. Screening for retinopathy of prematurity. Br J Ophthalmol 2002; 86: 1127-1130. 2.
  • Elder JE. Is it time to review the screening guidelines for
  • Gilbert C, Rahi J, Eckstein M, O’Sullivan J, Foster A. Retinopathy of prematurity in middle-income countries. Lancet 1997; 350: 12-14.
  • Carden SM, Lan LN, Huynh T. Zone 1 retinopathy of prematurity in a transitional economy: a cautionary note. Am J Ophthalmol 2006; 141: 1128-1129.
  • Kemper AR, Wallace DK. Neonatologists’ practice and experience in arranging retinopathy of prematurity screening services. Pediatrics 2007; 120: 527-531.
  • Holmstrom G, el Azazi M, Jacobson L, Sachs D, Sule J, Lennerstrand G. Epidemiology of retinopathy of prematurity in the Stockholm area of Sweden. Acta Ophthalmol Suppl 1993; 210: 44-47.
  • Fledelius HC, Rosenberg T. Retinopathy of prematurity. Where to set screening limits? Recommendations based on two Danish surveys. Acta Paediatr Scand 1990; 79: 906-10.
  • Canadian Association of Pediatric Ophthalmologists Ad Hoc Committee on Standards of Screening Examination for Retinopathy of Prematurity. Can J Ophthalmol 2000; 35: 251- 252.
  • See JLS, Wong TY, Yeo KT. Trends in the pattern of blindness and major ocular diseases in Singapore and Asia. Ann Acad Med 1998; 27: 540-546.
  • Ikeda N, Hayasaka S, Yano H, Kadoi C, Matsumoto M, Imamura H et al. Retinopathy of prematurity in Toyama area of Japan. Ann Ophthalmol 2001; 33: 303-308.
  • Yanovitch T, Siatkowski M, McCaffree MA, Corff KE. Retinopathy of prematurity in infants with birth weight >1250 grams - incidence, severity, and screening guideline cost- analysis. J AAPOS 2006; 10: 128-134.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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