Abstract
Objective. Current American retinopathy of prematurity (ROP) screening guidelines is imprecise for infants ≥ 30 weeks with birth weights between 1500 and 2000 g. Our objective was to evaluate a risk factor based approach for screening premature infants at low risk for severe ROP. Study Design. We performed a 13-year review from Intermountain Health Care (IHC) data. All neonates born at ≤32 weeks were reviewed to determine ROP screening and/or development of severe ROP. Severe ROP was defined by stage ≥ 3 or need for laser therapy. Regression analysis was used to identify significant risk factors for severe ROP. Results. We identified 4607 neonates ≤ 32 weeks gestation. Following exclusion for death, with no retinal exam or incomplete data, 2791 (61%) were included in the study. Overall, severe ROP occurred in 260 (9.3%), but only 11/1601 ≥ 29 weeks (0.7%). All infants with severe ROP ≥ 29 weeks had at least 2 identified ROP risk factors. Implementation of this risk based screening strategy to the IHC population over the timeline of this study would have eliminated screening in 21% (343/1601) of the screened population. Conclusions. Limiting ROP screening for infants ≥ 29 and ≤ 32 weeks to only those with clinical risk factors could significantly reduce screening exams while identifying all infants with severe ROP.
Highlights
Retinopathy of prematurity (ROP) is the second leading cause of childhood blindness in the United States and the main cause of severe visual impairment associated with prematurity [1]
A total of 4607 premature infants born at 32 weeks gestational age (GA) or less were reported to the Intermountain Health Care (IHC) database during the defined study period
Infants born at
Summary
Retinopathy of prematurity (ROP) is the second leading cause of childhood blindness in the United States and the main cause of severe visual impairment associated with prematurity [1]. According to the most recent American Academy of Pediatrics (AAP) guidelines, screening examinations for ROP are recommended for all infants born at a GA ≤ 30 weeks or with a birth weight ≤ 1500 g, as well as for those > 30 weeks with birth weights between 1500 and g with an unstable clinical course [5]. It remains unclear what defines an “unstable clinical course,” making it difficult to determine which babies in this more mature subgroup should be screened. Given that retinal examinations are costly and may be associated with pain and discomfort [9,10,11,12], efforts should continue to better define the target population of premature babies that would most benefit from ROP screening without missing at risk infants
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
