MAR 08, 2010
This non-randomized, retrospective study assigned 357 premature infants (712 eyes) weighing 401 to 1,250 g to either high- or low-risk pre-threshold or threshold ROP groups using a risk model based on variables of birth weight, gestational age, multiple birth, race and gender. High-risk eyes were screened conventionally using simulations, while low-risk eyes were screened with an alternative protocol, 35q3 (initial examination at 35 weeks postmenstrual age followed by screening every three weeks, with increased or decreased intervals based on ROP severity).
The authors found that the alternative method reduced the overall mean number of eye examinations per infant by 13.4 percent (p=0.0051), noting that this percentage would have been greater if more recent screening guidelines (which tend toward more frequent screening) had been used. There were no delays in detection of type 1 zone 1 ROP. Two eyes with the more severe, type 1 zone 2 ROP had a one-week delay in detection, although they regressed without progression to threshold ROP.
The study's authors concluded that while a risk-based, alternative screening protocol appears to increase ROP screening efficiency without loss of effectiveness, the approach is investigational and requires further validation by multicenter studies.