Abstract
Background/objectives
Screening for retinopathy of prematurity (ROP) is a core healthcare intervention in premature babies to avoid preventable sight loss. A variety of screening criteria are in place globally for this purpose. The Royal College of Paediatrics and Child Health recently updated the United Kingdom ROP screening guidelines (March 2022). A key change was the reduction in the gestational age (GA) to warrant retinal screening (from 32 to 31 weeks).
Subjects/methods
In the course of informal national surveillance during guideline development (2017–2022) and soon after, babies under our care falling outside the updated screening criteria who underwent treatment for ROP were identified. A retrospective case review was carried out.
Results
Six babies were identified as having undergone screening and treatment, prior to implementation of the new guidance. Screening and treatment would have been forfeited as per the March 2022 guidelines. All six had numerous systemic risk factors for developing ROP. Specifically, all had documented poor postnatal weight gain.
Conclusions
We present this case series to bring forth an urgent discussion amongst key stakeholders as to whether the new guidance, as it stands, is safe and fit for purpose.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 18 print issues and online access
$259.00 per year
only $14.39 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Wilkinson A, Haines L, Head K. UK retinopathy of prematurity guideline. Eye. 2009;23:2137–9.
Royal College of Paediatrics and Child Health. UK screening of retinopathy of prematurity guideline. March 2022. https://www.rcpch.ac.uk/resources/screening-retinopathy-prematurity-ropclinical-guideline.
Adams G, Williams C, Modi N, Xing W, Bunce C, UK Retinopathy of Prematurity Special Interest Groups. et al. Can we reduce the burden of the current UK guidelines for retinopathy of prematurity screening? Eye. 2018;32:235–7.
Adams GG, Bunce C, Xing W, Butler L, Long V, Reddy A, et al. Treatment trends for retinopathy of prematurity in the UK: active surveillance study of infants at risk. BMJ Open. 2017;7:67–71.
Fierson WM, American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening examination of premature infants for retinopathy of prematurity. Pediatrics. 2013;131:189–95.
Jalali S, Matalia J, Hussain A, Anand R. Modification of screening criteria for retinopathy of prematurity in India and other middle-income countries. Am J Ophthalmol. 2006;141:966–8.
Shah PK, Prabhu V, Karandikar SS, Ranjan R, Narendran V, Kalpana N. Retinopathy of prematurity: past, present and future. World J Clin Pediatr. 2016;5:35–46.
Yu CW, Popovic MM, Dhoot AS, Arjmand P, Muni RH, Tehrani NN, et al. Demographic risk factors of retinopathy of prematurity: a systematic review of population-based studies. Neonatology. 2022;119:151–63.
Fortes Filho JB, Bonomo PP, Maia M, Procianoy RS. Weight gain measured at 6 weeks after birth as a predictor for severe retinopathy of prematurity: study with 317 very low birth weight preterm babies. Graefes Arch Clin Exp Ophthalmol. 2009;247:831–6.
Binenbaum G, Ying GS, Quinn GE, Dreiseitl S, Karp K, Roberts RS, et al. Premature Infants in Need of Transfusion Study Group. A clinical prediction model to stratify retinopathy of prematurity risk using postnatal weight gain. Pediatrics. 2011;127:607–14.
Binenbaum G, Bell EF, Donohue P, Quinn G, Shaffer J, Tomlinson LA, et al. G-ROP Study Group. Development of modified screening criteria for retinopathy of prematurity: primary results from the postnatal growth and retinopathy of prematurity study. JAMA Ophthalmol. 2018;136:1034–40.
Binenbaum G, Tomlinson LA, de Alba Campomanes AG, Bell EF, Donohue P, Morrison D, et al. Validation of the postnatal growth and retinopathy of prematurity screening criteria. JAMA Ophthalmol. 2020;138:31–37.
Husain SM, Sinha AK, Bunce C, Arora P, Lopez W, Mun KS, et al. Relationships between maternal ethnicity, gestational age, birth weight, weight gain, and severe retinopathy of prematurity. J Pediatr. 2013;163:67–72.
Author information
Authors and Affiliations
Contributions
Concept of work: RJH, SA. Acquisition of data: all authors. Drafting of manuscript: RJH, SA. Reviewing manuscript critically: all authors. Final approval of manuscript: all authors. Accountability for all aspects of the work: RJH, SA.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Aulakh, S., Houtman, A.C., Rathod, D. et al. The Royal College of Paediatrics and Child Health Retinopathy of Prematurity Screening Guidelines (2022): a series of treated infants falling outside the updated criteria. Eye (2024). https://doi.org/10.1038/s41433-024-03076-3
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41433-024-03076-3