Systematic review of the guidelines for retinopathy of prematurity

Kościółek, Michał; Kisielewska, Weronika; Ćwiklik-Wierzbowska, Marlena; Wierzbowski, Piotr; Gilbert, Clare

doi:10.1177/11206721221126286

Cited by 5 publications

(6 citation statements)

References 34 publications

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“…In general, there has been a tendency to use flexible criteria in low- and middle-income countries (e.g., GA ≤32 or 37), and stricter criteria in high-income countries (e.g., GA ≤30). [ 27 ]…”

Section: Discussionmentioning

confidence: 99%

The impact after 20 years of an early detection program for severe retinopathy of prematurity in a Latin American city

Zuluaga-Botero,

Cantor,

Bonilla

et al. 2023

Indian Journal of Ophthalmology

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Purpose: To evaluate the effects of long-standing early detection program in the incidence and trends of severe retinopathy of prematurity (ROP) in Cali, Colombia. Methods: This was a retrospective cohort study of infants included in an ROP prevention, early detection, and prompt treatment program, from January 01, 2002, to December 31, 2021 (20 years). Infants with gestational age (GA) <37 weeks or birth weight (BW) <2000 g and those with known ROP risk factors were screened. The incidence of severe ROP was calculated, and the average annual percent change (AAPC) was estimated through a joinpoint model. Results: 16,580 infants were screened, with an average GA and BW of 31.4 ± 2.8 weeks and 1526.5 ± 56.7 g, respectively. The incidence of severe ROP was 2.69% (446 cases, 95% confidence interval [95%CI]: 2.45%; 2.95%), with an average annual decrease of − 14% (AAPC, 95%CI: −16.3%; −11.6%) from 13.6% in 2002 to 0.7% in 2021. In infants with GA <32 weeks, the incidence was 5.21%. A significant reduction in the risk of ROP was observed with increasing GA and BW (P < 0.05). Among the cases with severe ROP, 6.5% (29/446) had a GA ≥32 weeks with a maximum of 37 weeks; only 0.4% (2/446) of the detected infants had a BW >2000 g. Conclusion: Awareness and screening as part of the early detection program to prevent ROP has shown a significant decline in the incidence of severe ROP over time. Screening infants with GA <32 weeks or BW <2000 g and preterm infants (<37 weeks) with risk factors may be a feasible decision for resource optimization.

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Section: Discussionmentioning

confidence: 99%

The impact after 20 years of an early detection program for severe retinopathy of prematurity in a Latin American city

Zuluaga-Botero,

Cantor,

Bonilla

et al. 2023

Indian Journal of Ophthalmology

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“…Studies were eligible for inclusion when (unadjusted) data were reported on HCA with or without FUN in preterm neonates (<37 weeks' GA and/or BW < 2,000 g) with ROP. 11 12 Articles were excluded when the study population consisted entirely of animals or multiple pregnancies due to its confounding effect. 13 Additionally, articles were excluded when placenta reports were unavailable to histologically confirm CA in cases with CCA, which is diagnosed by nonspecific clinical symptoms.…”

Section: Methodsmentioning

confidence: 99%

Histological Chorioamnionitis and Funisitis as New Risk Factors for Retinopathy of Prematurity: A Meta-analysis

El Emrani,

Jansen,

Goeman

et al. 2023

Am J Perinatol

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Objective The role of placental inflammation in neonatal morbidities is underestimated due to lack of placental examination. This meta-analysis aims to assess the association between histological chorioamnionitis (HCA) with and without funisitis (FUN) and risk of retinopathy of prematurity (ROP). Study Design Forty-five studies reporting (unadjusted) data on HCA without FUN and HCA with FUN in neonates with ROP were included. Primary outcomes were any stage ROP and severe ROP. Potential confounders explored were gestational age (GA) at birth, birthweight, maternal steroid use, necrotizing enterocolitis, sepsis (suspected/proven) and mechanical ventilation duration. Results Neonates with HCA had increased risk for any stage ROP (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.3–2.4) and severe ROP (OR 1.5; 95% CI 1.2–1.8) compared with neonates without HCA. The rates of any stage ROP (OR 1.8; 95% CI 1.4–2.2) and severe ROP (OR 1.4; 95% CI 1.1–1.6) were higher in neonates with FUN compared with neonates without FUN. Multivariate meta-regression analysis suggests that lower GA increases the effect size between FUN and severe ROP. Conclusion This meta-analysis confirms that presence of HCA and FUN are risk factors for any stage ROP and severe ROP. Structured histological placental examination of HCA and FUN may be a tool to further refine the ROP risk profile. Key Points

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“…Screening for ROP, which should include all eligible infants according to local guidelines, starts within weeks of birth 12. Unlike screening for other conditions, which usually entails a one-off procedure, screening for ROP may need to be repeated at frequent intervals depending on the clinical findings.…”

Section: Introductionmentioning

confidence: 99%

Improved screening of retinopathy of prematurity (ROP): development of a target product profile (TPP) for resource-limited settings

et al. 2023

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BackgroundAs more preterm infants survive, complications of preterm birth, including retinopathy of prematurity (ROP), become more prevalent. ROP rates and blindness from ROP are higher in low-income and middle-income countries, where exposure to risk factors can be higher and where detection and treatment of ROP are under-resourced or non-existent. Access to low-cost imaging devices would improve remote screening capabilities for ROP.MethodsTarget product profiles (TPPs) are developed early in the medical device development process to define the setting, target user and range of product requirements. A Delphi-like process, consisting of an online survey and consensus meeting, was used to develop a TPP for an ROP imaging device, collecting feedback on a proposed set of 64 product requirements.ResultsThirty-six stakeholders from 17 countries provided feedback: clinicians (72%), product developers (14%), technicians (6%) and other (8%). Thirty-six per cent reported not currently screening for ROP, with cited barriers including cost (44%), no training (17%) and poor image quality (16%). Among those screening (n=23), 48% use more than one device, with the most common being an indirect ophthalmoscope (87%), followed by RetCam (26%) and smartphone with image capture (26%). Consensus was reached on 53 (83%) product requirements. The 11 remaining were discussed at the consensus meeting, and all but two achieved consensus.ConclusionsThis TPP process was novel in that it successfully brought together diverse stakeholders to reach consensus on the product requirements for an ROP imaging devices. The resulting TPP provides a framework from which innovators can develop prototypes.

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Systematic review of the guidelines for retinopathy of prematurity

Cited by 5 publications

References 34 publications

The impact after 20 years of an early detection program for severe retinopathy of prematurity in a Latin American city

The impact after 20 years of an early detection program for severe retinopathy of prematurity in a Latin American city

Histological Chorioamnionitis and Funisitis as New Risk Factors for Retinopathy of Prematurity: A Meta-analysis

Improved screening of retinopathy of prematurity (ROP): development of a target product profile (TPP) for resource-limited settings

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