Screening Examination of Premature Infants for Retinopathy of Prematurity

Abstract

This policy statement revises a previous statement on screening of preterm infants for retinopathy of prematurity (ROP) that was published in 2013. ROP is a pathologic process that occurs in immature retinal tissue and can progress to a tractional retinal detachment, which may then result in visual loss or blindness. For more than 3 decades, treatment of severe ROP that markedly decreases the incidence of this poor visual outcome has been available. However, severe, treatment-requiring ROP must be diagnosed in a timely fashion to be treated effectively. The sequential nature of ROP requires that infants who are at-risk and preterm be examined at proper times and intervals to detect the changes of ROP before they become destructive. This statement presents the attributes of an effective program to detect and treat ROP, including the timing of initial and follow-up examinations.

Vision in former very low birthweight young adults with and without retinopathy of prematurity compared with term born controls: the NZ 1986 VLBW follow-up study

“…Given this it seems likely that had laser therapy been available and Early Treatment for Retinopathy of Prematurity study  (ET-ROP) criteria followed in 1986 useful vision might have been preserved in most of the six individuals who progressed to bilateral retinal detachments. Excluding these infants there were 21 others who had plus disease (Darlow, unpublished data, 1986), thus meeting ET-ROP type 1 criteria for treatment,15 and 12 of these underwent visual assessments at 27–29 years. Two-thirds of this group had no or only mild visual impairment and one-third moderate visual impairment in the better eye.…”

Retinopathy of prematurity screening criteria in Iran: new screening guidelines

“…The UK, the USA and Canada20 along with China and other countries28 29 have developed evidence-based screening criteria that continue to be reviewed as the population of infants who are at risk changes over time 5 18 30…”

“…It is recommended that each country develops and employs its own specific screening criteria appropriate for its local population 4. The latest American Academy of Pediatrics (AAP) screening guidelines for ROP recommends mandatory screening for infants with birth weights (BWs) ≤1500 g or gestational ages (GAs) ≤30 weeks 5. These guidelines have been shown to be inadequate for screening in low/middle-income countries 6–8…”

Lutein facilitates physiological revascularization in a mouse model of retinopathy of prematurity

“…Three recent randomized controlled trial studies of lutein in ROP patients reported that lutein appeared to be ineffective in preventing proliferative ROP in preterm infants . However, a decreasing trend of the progression rate from early ROP stages to threshold ROP (defined as beyond which there is 50% likelihood of the incidence of unfavourable outcomes) was shown . Therefore, the effect of lutein in ROP needs to be further assessed.…”