Restricted universal guidelines for ROP screening: A possible misguidance for middle income countries

Authors: ÖMER ERDEVE, BEGÜM ATASAY, SAADET ARSAN, FİGEN BATUOĞLU, HUBAN ATİLLA, TOMRİS TÜRMEN

Abstract: The objective of all studies evaluating retinopathy of prematurity (ROP) screening criteria has been to minimize the number of infants screened while missing no patients with ROP who required treatment. Studies supporting the recommendation that screening for ROP could be restricted to infants born at less than 30 weeks of gestation with birth weights of less than 1250 g have been reported recently, especially from Western countries. However, with the lack of local outcome data, application of the new restricted screening guidelines to infants in middle income countries may lead to misguidance. We aimed to investigate ROP screening requirements in infants born at more than 30 weeks of gestation with birth weights above 1250 g in our unit and to compare them with different countries’ screening guidelines to assess the possible risk of restricted guidelines in our unit. Materials and methods: Retinopathy screening results were analyzed in relevance to the birth weight, gestational age, and contributing clinical factors. Infants who had a gestational age of 30 weeks or less and a birth weight less than or equal to 1250 g (Group 1) were compared to those who had a gestational age greater than 30 weeks and a birth weight greater than 1250 g (Group 2). Results: Among 226 live premature infants, 51 (22.5%) of them required laser treatment. No patient developed blindness. The majority of patients who required laser treatment (n = 27, 53%) belonged to Group 2. Conclusion: This study showed that applying developed countries’ guidelines might lead to a misdiagnosis of many patients who require treatment. Restriction criteria in retinopathy screening guidelines should be based on local population studies of the disease, not on results from other regions like high income countries.

Keywords: Premature, retinopathy of prematurity, screening

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