Abstract
Retinopathy of prematurity (ROP) is the main cause of avoidable blindness in children in Mexico despite National ROP Guidelines and examination of preterm infants being a legal requirement. Objective. To assess coverage of ROP programs and their compliance with national guidelines. Study Design. Thirty-two neonatal intensive care units (NICUs) in five of the largest states were visited. Staff were interviewed to collect information on their ROP programs which were defined as (1) compliant, if National Guidelines for screening and treatment were followed, (2) noncompliant, if other approaches were used, or (3) no program. Results. Only 10 (31.2%) had fully compliant programs and 11 (34.4%) had no program. In the remaining 11 (34.4%) different screening criteria were used (7 units): screening was undertaken by an ophthalmologist in unsalaried time (4), was not undertaken in the NICU (2), and was undertaken by a neonatologist (1) and/or Avastin was used as first-line treatment (7). Poorer states had poorer programs. Conclusions. Despite legislation mandating eye examination of preterm births, many ROP programs in the largest cities in Mexico require improvement or need to be established. Prevention of blindness due to ROP needs to be prioritized in Mexico to control the epidemic of ROP blindness.
Highlights
Recent estimates, which used statistical modelling of data on preterm birth rates, access to neonatal care and survival rates, rates of retinopathy of prematurity (ROP) requiring treatment, the proportion of these infants treated, and the outcome of treatment, suggest that 32,000 preterm infants became blind or visually impaired globally in the year 2010 from ROP [1]
The findings of this study show that much needs to be done to improve the coverage and quality of programs for the detection and treatment of ROP in Mexico, even in the capital city where five of the nine neonatal intensive care units (NICUs) visited did not have a program
Greater awareness is needed amongst policy makers and planners, so that they are made aware of Pan American Health Organization (PAHO) priorities for the region and the National ROP Guidelines and that eye examination of preterm infants is a legal requirement
Summary
Recent estimates, which used statistical modelling of data on preterm birth rates, access to neonatal care and survival rates, rates of retinopathy of prematurity (ROP) requiring treatment, the proportion of these infants treated, and the outcome of treatment, suggest that 32,000 preterm infants (uncertainty range 24,800–44,500) became blind or visually impaired globally in the year 2010 from ROP [1]. These estimates are higher than those of a decade ago, which were based on childhood blindness prevalence estimates and the proportion of blindness due to ROP [2]. Almost half of these children (46%) had not been treated for ROP
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