Optimal Timing of the First Screening Examination for Retinopathy of Prematurity

Kim, Ji Soo; Kim, Sae Yun; Lee, Juyoung; Kim, Jeong Hun; Kim, Ee Kyung; Kim, Han Suk; Yu, Young Suk; Choi, Jung Hwan

Abstract

PURPOSE
In the present study, we aimed to evaluate the suitability of the first screening examination for retinopathy of prematurity (ROP) in a tertiary neonatal intensive care unit (NICU).
METHODS
A retrospective analysis of ROP screening records of 459 infants admitted to the NICU of Seoul National University Children's Hospital between January 2006 and December 2011 was performed. The first examination was performed at 31-32 weeks of postmenstrual age (PMA) or 4-5 weeks of postnatal age (PNA), whichever was earlier. The infants were divided into subgroups according to the gestational age (GA), and the time of the first examination, time of onset of ROP, and time of laser surgery were assessed with regard to the PMA and PNA.
RESULTS
Of the 459 infants, 139 infants developed ROP, with the mean PMA at onset of ROP being 34+2+/-2+3 weeks. Type I ROP developed in 57 infants, with the median PMA at laser surgery being 36+0 weeks. The median PMAs at the time of onset and the time of surgery did not significantly differ between groups divided according to GA. Infants with a GA of <26 weeks showed a higher incidence of Type I ROP compared to those with a GA of > or =26 weeks. None of the infants with a GA of <26 weeks were diagnosed with ROP at the first examination, and none of the patients in either group missed treatment. Six infants developed ROP before 31 weeks of PMA, at which time the first screening for ROP is generally performed.
CONCLUSION
We suggest that the timing of the initial examination for ROP should be based on PMA or PNA, whichever is earlier, particularly in infants with GA of <26 weeks.