Towards a universal approach for screening of retinopathy of prematurity (ROP)

Schalij‐Delfos, Nicoline E.; Zijlmans, Bart L.M.; Cats, B. P.

doi:10.1007/bf02583285

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…They concluded that ROP screening is distressing for preterm infants. 15 Various authors [16][17][18] have highlighted the underlying costs of screening premature babies and the screening is an additional commitment for an already overstretched ophthalmic department. Anything that would reduce the frequency of undertaking this task would be welcome.…”

Section: Discussionmentioning

confidence: 99%

Retinopathy of prematurity: are we screening too many babies?

Mathew

Fern

Hill

2002

Eye

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Purpose With advancement in neonatal care units, early detection of retinopathy of prematurity (ROP) in premature and verylow-birth-weight infants is important. Numerous studies have reported an increased risk of ROP in prematurely born infants, but only few have been long-term and strictly population-based. The aim of the present study was to find out whether birthweight Ͻ1251 grams and gestational age Ͻ30 weeks could provide a safe and efficient means of detecting treatable ROP. We have retrospectively tried to ascertain the incidence and associated risk factors that may contribute to the management of babies with ROP. Methods Infants either with a birth weight below 1500 g or a gestational age of less than 32 weeks were screened for ROP during an 8-year period by a single examiner. Results An incidence of 64/205 (31.2%) ROP was noted. The mean age at detection was 5.5 ؎ 2 weeks of life. The maximum stage reached was stage 1 in 27 (13.2%), stage 2 in 24 (11.7%) and stage 3 in 10 (4.8%) babies. Threshold ROP was present in three (1.5%) babies. Significantly fewer (150/205 = 73%) babies would have been examined had a birth weight of Ͻ1251 grams and a gestational age Ͻ30 weeks been applied. There were five (8%) babies with birth weight Ͼ1250 grams and eight (12%) babies with gestational age Ͼ30 weeks amongst babies with ROP but all were stage 1 or stage 2. All the stage 3 ROP and the threshold ROP cases were babies with birth weight Ͻ1000 grams and gestational age below 28 weeks. Conclusion Ophthalmic examination may be safely and efficiently concentrated in babies with birth weight Ͻ1251 grams and gestational age below 30 weeks. Birth weight (P Ͻ 0.005) and gestational age (P Ͻ 0.01) were the only significant risk factors. During this 8-year period there was no significant decrease in the number of babies screened for ROP and the overall incidence of all stages of the disease has remained constant. In the present series a lower incidence of severe ROP was noted compared to most previous studies. Our experience from this study suggests the need for further refinement of screening guidelines in order to focus screening on the vision-threatening stages of ROP.

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Section: Discussionmentioning

confidence: 99%

Retinopathy of prematurity: are we screening too many babies?

Mathew

Fern

Hill

2002

Eye

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“…Infants with a gestational age ⩽32 weeks and/or a birth weight <1500 g were screened for ROP from their fifth week of life onwards, according to our protocol 8. Parents of these infants were asked for permission to include their child in the study.…”

Section: Methodsmentioning

confidence: 99%

Long term follow up of premature infants: detection of strabismus, amblyopia, and refractive errors

Schalij‐Delfos¹,

Graaf²,

Treffers³

et al. 2000

British Journal of Ophthalmology

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Aim-To establish recommendations for long term ophthalmological follow up of prematurely born infants. Methods-130 infants with a gestational age (GA) <37 weeks and born between 1 November 1989 and 31 October 1990 were enrolled in a prospective study about the development of strabismus, amblyopia, and refractive errors. Infants were subdivided in three groups according to GA: A <28 weeks (n=32), B >28-<32 weeks (n=64), C >32-<37 weeks (n=34). Ophthalmological assessment took place at the postconceptional age of 32 weeks, at term and at 3, 6, 12, and 30 months post term. At the age of 5 years parents received a questionnaire and a majority of the children was examined again (n=99). Results-At the age of 5 years 46 infants were known to have strabismus (n=29) and/or amblyopia (n=22) and/or refractive errors (n=22). Statistical analysis showed that gestational age, duration of supplementary oxygen, and duration of hospitalisation were important predictive variables for the development of strabismus, amblyopia, or refractive errors (SAR) at the age of 5 years (p<0.05). Infants with a GA <32 weeks had a significantly higher risk of developing SAR than infants with a GA >32 weeks, who developed an incidence comparable with the normal population. Strabismus developed mainly in the first year of life and at the age of 5 years. Most infants with amblyopia were detected at the age of 2-3 years. Refractive errors were found in the first year of life and at the age of 2.5 and 5 years. Conclusion-Infants with a GA <32 weeks should be selected for long term ophthalmological follow up. These infants should be screened at the age of 1 year, in the third year of life (preferably at 30 months), and just before school age (including testing of visual acuity with optotypes). (Br J Ophthalmol 2000;84:963-967)

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“…obtained with similarly few eyes (19,10.6%) that were incorrectly categorized as low risk (e-Supplement 4, available at jaapos.org). A slightly lower specificity (68.2%) was achieved as compared with UHC infants.…”

Section: Application Of Risk Model To a Different Infant Populationmentioning

confidence: 99%

“…17 Likewise, a simulation study that reduced ROP screening frequency from biweekly to monthly intervals for premature infants \1,251 g BW suggested that additional cases of blindness would occur that nullify the cost savings from a reduction in screening. 18 Other studies used a risk model with prognostic variables of BW, GA, and either the duration of oxygen therapy 19 or the number of erythrocyte transfusions 20 to select low-risk infants for alternative screening. Low-risk infants were either screened once at 7 weeks chronological age 19 or not at all.…”

Section: Introductionmentioning

confidence: 99%

“…18 Other studies used a risk model with prognostic variables of BW, GA, and either the duration of oxygen therapy 19 or the number of erythrocyte transfusions 20 to select low-risk infants for alternative screening. Low-risk infants were either screened once at 7 weeks chronological age 19 or not at all. 20 In both studies, no cases of ROP greater than stage 3 were missed, and eye examinations were reduced.…”

Section: Introductionmentioning

confidence: 99%

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