Applicability of American and British criteria for screening of the retinopathy of prematurity in Thailand.

Abstract

The aim of this study was to verify the applicability of standard guidelines for the screening of retinopathy of prematurity (ROP) and to determine the appropriate criteria for Thai neonates. Records of ROP screening of infants born in our hospital between 1995 and 2000 with a birth weight below 2000 g or a gestational age of less than 36 weeks were studied. Criteria to screen infants with a birth weight below 1500 g or a gestational age of less than 28 weeks in the American guidelines and similar birth weight but a gestational age of less than 31 weeks in the British recommended guidelines were applied and evaluated in terms of sensitivity and specificity. Criteria reaching 100% sensitivity with the maximum specificity were deemed appropriate. Of the 514 screened infants, 33 had developed stage 2+ ROP and beyond. The mean +/- SD birth weight and gestational age were 1046 +/- 257 (710-1680 g) and 29.2 +/- 2.5 weeks (24-35 weeks), respectively. The age at intervention was 6-16 weeks. Sensitivity for both American and British guidelines was 93.9%. By screening infants with birth weights below 1500 g or gestational age less than 33 weeks, we could achieve 100% sensitivity with 18.3% specificity. We decided that the initial examination should be performed 4-6 weeks after birth. By applying these criteria to 62 referred cases we also were able to include in the screening all cases of concern in this group. Regional criteria for ROP screening is required and should be evaluated periodically and modified accordingly.