Retinopathy of Prematurity Outcomes of Neonates Meeting only a Single Screening Criterion: Proposal of the TWO-ROP Algorithm: Single Screening Criterion for Retinopathy of Prematurity by Nimesh A Patel

CONCLUSIONS: Patients meeting one screening criterion had a low rate of ROP (

Am J Ophthalmol. 2023 Mar 17:S0002-9394(23)00100-9. doi: 10.1016/j.ajo.2023.03.007. Online ahead of print.


PURPOSE: To assess the rates of retinopathy of prematurity (ROP) and treatment-warranted ROP in a modern set of patients meeting zero or one of the current ROP screening criteria.

DESIGN: Retrospective cohort study.

METHODS: Single-center study of 9,350 infants screened for ROP from 2009-2019. Rates of ROP and treatment-warranted ROP were evaluated in group 1 (BW < 1500g and GA ≥ 30weeks), group 2 (BW ≥ 1500g and GA < 30 weeks), and group 3 (BW ≥ 1500g and GA ≥ 30weeks).

RESULTS: Out of 7,520 patients with reported BW and GA, 1,612 (21.4%) patients met the inclusion criteria. The number of patients in group 1, 2, and 3 was 466 (6.19%), 23 (0.31%), and 1123 (14.93%) respectively. The number of patients diagnosed with ROP was 20 (4.29%) in group 1, 1 (4.35%) in group 2, and 12 (1.07%) in group 3, P < .001. Mean interval between birth and ROP diagnosis was 36.25 days (range 12 – 75) in group 1, 47 days in group 2 and 23.33 days (range 10 – 39) in group 3 (P = .05). No cases of stage 3, zone 1 or plus disease were recorded. No patient met the treatment criteria.

CONCLUSIONS: Patients meeting one screening criterion had a low rate of ROP (<5%), with no stage 3, zone 1, or plus disease. No patients required treatment. We propose a possible algorithm (TWO-ROP) in appropriate NICUs, with an amendment in screening protocol for this low-risk population to include only an outpatient screening exam within 1 week of discharge, or at 40 weeks if inpatient, to decrease the inpatient ROP screening burden while maintaining safety. Further external validation of this protocol would be required.

PMID:36933856 | DOI:10.1016/j.ajo.2023.03.007

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