Retinopathy of prematurity: are we missing any infant with retinopathy of prematurity?

Aims: To evaluate incidence of retinopathy of prematurity (ROP) and validity of current ROP screening criteria adopted in the Armed Forces Hospitals.

Methods: A retrospective study of ROP indices was carried out in infants admitted to the neonatal intensive care unit in Khamis Mushait, Saudi Arabia, from January 2009 to December 2011. All infants who had birth weight (BW) of 1500 g or less and/or gestational age (GA) of 32 weeks or less had their data reviewed for ROP diagnosis and related indices. Some heavier or older infants were also included in the study.

Results: 386 infants were screened and ROP was diagnosed in 90 infants (23.31%). 25 infants (6.47%) had type 1 or worse ROP and were treated with cryopexy or laser. For patients having ROP, the mean GA was 27.8 ± 2 weeks and mean BW was 961.8 ± 237.4 g. Infants who needed treatment for ROP had a mean BW of 828.8 ± 192.8 g and mean GA of 27 ± 1.8 weeks. All infants who developed ROP fulfilled both or one criterion of ROP screening. No infant greater than 1350 g BW or more than 31 weeks GA was treated for ROP.

Conclusions: Current ROP screening criteria of BW of 1500 g or less and/or GA of 32 weeks or less seems reasonable in our set up as no infant having ROP was missed by using these criteria. We do not recommend lowering or using only one index for ROP screening.