Repeated ROP screenings may not be needed in lower-risk populations

A large multicenter cohort study was conducted to validate findings from the earlier E-ROP study, which found that no infants who had a birth weight >750 g and were born at or after 27 weeks’ gestational age developed new treatable retinopathy of prematurity (ROP) after 37 weeks’ gestational age.

Study design

This was a retrospective review of all infants screened (6729) and treated (298) for ROP at 6 hospitals in Tennessee over a 19-year period. The age at which ROP was diagnosed and ROP risk factors, including birth weight and gestational age, were evaluated.

Outcomes

Ten of the infants who required ROP treatment developed ROP after 37 weeks’ gestational age; however, all but one met other criteria for continued screening (birth weight <750 g or birth at or before 27 weeks’ gestational age). The one patient technically did not meet criteria for treatment-warranted ROP, but underwent treatment due to other constraints.

Limitations

Data were included from 6 different hospitals, each of which may have its own neonatal intensive care unit practice patterns.

Clinical significance

Premature infants at low risk for developing ROP (birth weight >750 g and birth at or after 27 weeks’ gestational age) who have no detectable ROP at the first exam after 37 weeks’ gestational age are unlikely to develop ROP that requires treatment. Therefore, ROP screening may not be warranted in this low-risk population. Continued evaluation of current guidelines is required to balance the importance of disease detection with screening burden.

Financial Disclosures: Dr. Brenda Bohnsack discloses no financial relationships.