Retinopathy of prematurity: Recommendations for screening

Retinopathy of prematurity (ROP) is a disorder that can cause blindness in premature infants. It is now known that many infants with this disorder who are treated with ablative therapy in a timely fashion will avoid this serious outcome. It is essential that those caring for premature infants know who is at risk of retinopathy of prematurity, when screening must begin and how often these infants need to be examined. It is also important to know when to treat those infants who develop severe retinopathy of prematurity and what long term follow-up is needed to manage other complications of retinopathy of prematurity. Table 1 provides answers to these questions. The background data upon which these recommendations are based are found in the accompanying article (pages 173–180) in this issue of Paediatrics & Child Health.

TABLE 1:

Summary of recommendations for screening the Canadian population

Risk group	Infants 30 weeks gestational age or younger or Infants 1500 g or less birth weight
Who examines the eyes	Observer skilled in the recognition of retinopathy of prematurity, usually an ophthalmologist
Schedule of assessments	First examination at four to six weeks postnatal age Two to four weeks after the first examination if retinopathy of prematurity does not exist More frequent examinationss as determined by the ophthalmologist if retinopathy of prematurity does exist on any examination
Long term follow-up	Within six to 12 months corrected gestational age At age four years

The recommendations are based on currently available information. Further research is needed in the following areas: systematic reviews of new therapies (eg, surfactant) and their impact on ROP; prevention of ROP; randomized trials of the currently available surgical treatment for ROP; and a Canadian surveillance system for ROP.