Are we screening too many babies for retinopathy of prematurity?

Goble, R R; Jones, Huw; Fielder, Alistair R.

doi:10.1038/eye.1997.136

Cited by 62 publications

(49 citation statements)

References 32 publications

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“…While we adopt the Royal College Recommendations of screening infants less than 1500 g, we are in agreement with studies [13][14][15] that recommend lowering the BW criterion for screening infants for ROP to 1250 g. None of our patients over 1250 g developed tROP. This would have decreased the number of babies screened by 38% in our study.…”

Section: Eyesupporting

confidence: 83%

Retinopathy of prematurity in South Africans at a tertiary hospital: a prospective study

Mayet

Cockinos

2005

Eye

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Background and Objectives World Health Organization's vision 20/20 programme has recognized retinopathy of prematurity (ROP) as an important cause of childhood blindness in industrialized and middle-income countries. While ROP is virtually nonexistent in many African countries, ROP is seen in urban areas where facilities for neonatal care exist. The aim of this study is to establish the frequency of ROP in a cohort of patients screened for ROP and to establish if current screening criteria apply to our patients. Patients and Methods Infants with birth weight (BW) of 1500 g or less and/or gestational age of 32 weeks or less were screened for ROP over a 2 1 2 Àyear period by a single examiner. Results ROP was observed in 84 of 514 (16.3%) of infants included for analysis. Threshold disease (tROP) was noted in 1.6% of the total cohort although 41/84 babies with ROP were lost prior to regression or progression to tROP. Of the 43/84 adequately followed up, eight (18.6%) developed tROP. An estimated frequency of tROP was more likely to be 2.9%. There was no tROP noted in babies of BW greater than 1250 g. Gestational age was an unreliable risk parameter in our population. Conclusion The projected occurrence rate of tROP is similar to that found in black population in the Multicentre Cryotherapy for ROP Trial. Our data suggest that the screening criterion based on BW can safely be lowered to 1250 g in our population.

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Section: Eyesupporting

confidence: 83%

Retinopathy of prematurity in South Africans at a tertiary hospital: a prospective study

Mayet

Cockinos

2005

Eye

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“…This contrasts with acute ROP in 50.9% and stage 3/4 ROP in 4.7% reported from Leicester, Nottingham, and Derby between 1985 and 1987 10 and stage 3 ROP in 2.2% of Birmingham babies studied between 1989 and 1995. 4 It is to be expected that observer bias may influence the results of studies of this nature, but these two particular reports involved the same ophthalmologist as screener. Patient demographics may have an effect, as ROP increases in severity with reducing BW and GA.…”

Section: Incidence Of Ropmentioning

confidence: 99%

“…As previous studies have shown a geographical variation in the incidence of threshold ROP in babies born at similar gestational ages, [2][3][4] it is important to continue to analyse screening data from different regions in order to inform the debate. It is likely that screening criteria will have to be specifically defined for particular populations.…”

Section: Introductionmentioning

confidence: 99%

Retinopathy of prematurity in practice. I: screening for threshold disease

Brennan

Gnanaraj

Cottrell

2003

Eye

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Aims To review an 11-year period of screening for retinopathy of prematurity (ROP) in the north of England by a single ophthalmologist. To identify the gestational ages and birth weights of babies reaching different stages of ROP. To investigate the workload involved in screening to detect threshold ROP, and that the practical outcomes had narrower inclusion criteria for screening. To identify babies treated for threshold disease. Methods During the period August 1987-October 1998, babies were screened according to the national guidelines and the results were prospectively entered onto a computerised database. These data were then systematically reviewed. Results Data were available for 484 babies: 203 (41.9%) developed any ROP, 46 (9.5%) reached stage 3 ROP, and 25 (5.2%) reached threshold and were treated. Data on 425 babies showed them to require an average of 2.3 screening examinations per baby. It took an average of 39 screening examinations to detect one case of threshold ROP. The more premature and lighter birth weight babies required the most examinations. Therefore, restricting the inclusion criteria for screening would only have reduced the total number of screenings modestly and could have allowed us to miss two of our threshold cases who were both of 30 weeks gestational age and 41400 g birth weight.Conclusions Screening is time consuming but worthwhile in view of the benefits of treatment. As applied to babies in the north of England, the current national screening criteria are satisfactory. The results of treatment of the babies identified in this study are presented in the accompanying paper.

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“…11 Accurate delineation of the population of infants who are at risk for potentially blinding ROP is essential, providing the evidence on which to base guidelines regarding which infants need to be examined. The United Kingdom, the United States, and Canada, 4,[12][13][14][15][16] along with several other countries, have developed evidencebased screening criteria, which continue to be reviewed as the population of infants who are at risk changes over time. Information on the population of infants who develop treatable ROP is required from less developed countries, to develop screening programs that include all premature infants who are at risk.…”

mentioning

confidence: 99%

Characteristics of Infants With Severe Retinopathy of Prematurity in Countries With Low, Moderate, and High Levels of Development: Implications for Screening Programs

et al. 2005

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ABSTRACT. Objective. Retinopathy of prematurity (ROP) is a potentially avoidable cause of blindness in children. The proportion of blindness as a result of ROP varies greatly among countries depending on their level of development, being influenced by the availability of neonatal care, neonatal outcomes, and whether effective screening and treatment programs are in place. The objective of this study was to compare characteristics of premature infants who developed severe ROP between 1996 and 2002 in highly developed countries with less developed countries.Methods. This was an observational study. A questionnaire was completed by ophthalmologists in countries with low, moderate, and high development rankings (3 highly developed countries and from 10 less welldeveloped countries) who screen for ROP in which they supplied birth weights and gestational ages (GAs) of infants who were treated for threshold ROP or identified with more advanced stages of the disease. Birth weights and GAs of infants with severe ROP were measured.Results. The mean birth weights of infants from highly developed countries ranged from 737 to 763 g compared with values ranging from 903 to 1527 g in less developed countries. Mean GAs of infants from highly developed countries ranged from 25.3 to 25.6 weeks compared with 26.3 to 33.5 weeks in less developed countries. A total of 13.0% of 1091 infants from poorly developed countries exceeded United Kingdom screening criteria; 3.6% exceeded a criteria of <34 weeks' GA and/or <1750 g birth weight.Conclusions. These findings suggest that larger, more mature infants are developing severe ROP in countries with low/moderate levels of development compared with highly developed countries. ROP screening programs need to use criteria that are appropriate for their local population. Pediatrics 2005;115:e518-e525. URL: www. pediatrics.org/cgi

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Are we screening too many babies for retinopathy of prematurity?

Cited by 62 publications

References 32 publications

Retinopathy of prematurity in South Africans at a tertiary hospital: a prospective study

Retinopathy of prematurity in South Africans at a tertiary hospital: a prospective study

Retinopathy of prematurity in practice. I: screening for threshold disease

Characteristics of Infants With Severe Retinopathy of Prematurity in Countries With Low, Moderate, and High Levels of Development: Implications for Screening Programs

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