Current Perspectives in the Management of Retinopathy of Prematurity

ROP screening and treatment in four district-level special newborn care units in India: a cross-sectional study of screening and treatment rates

“…Eligibility for screening was defined according to the Indian national guidelines, that is, BW ≤2000 g or GA <34 weeks, or GA between 34 and 36 weeks if exposed to factors such as prolonged supplemental oxygen, respiratory distress syndrome or blood transfusions. 12 An infant was designated as ‘screened’ if they were screened even once. Screening was considered complete if the last follow-up visit had been attended or if an infant had missed only one follow-up visit.…”

“… 11 The current recommendations are that preterm infants or infants without known gestational age (GA) and with a birth weight (BW) up to 2000 g should be screened. 12 Natural history of ROP requires the first screening to be at an appropriate interval after birth, according to national guidelines; in India, the recommendation is by chronological age of 30 days regardless of GA. 12 This decision was made for three main reasons; first, except for a very small numbers the majority of these preterm infants develop ROP by 4–5 weeks, 13 second, it is easy for service providers and parents to understand and remember, and third, postmenstrual age cannot be used as GA is often unreliable. For a programme to be effective, it is important that all eligible infants are screened at the right time, which includes those who have been discharged or referred to a different unit, 13 as failure to screen, or inadequate screening are important reasons why infants become blind from ROP despite a programme being in place.…”

“… 7 The programme, which ended in June 2019, was supported by the UK’s Queen Elizabeth Diamond Jubilee Trust (the Trust) and was managed by Indian Institute of Public Health Hyderabad. In this programme, infants admitted to 20 SNCUs in 4 states who met the eligibility criteria recommended in the national ROP guidelines 12 were screened in the SNCU, and discharged infants were asked to return to the same hospital for further screening, if indicated. In this study, four SNCUs in one of the four states were visited 4 months after initiation of the programme and data of the first 3 months were included.…”