I just wanted to link to the 2013 Guidelines for ROP Screening issued by AAP

http://pediatrics.aappublications.org/content/131/1/189.long

Has anyone modified practice after the new guidelines have come out ?

Interesting document!

We had new national guidelines (Sweden) last year and we screen infants born below <31 weeks (born ≤ w30+6).

(previously infants born ≤ w31+6 were screened)

AAP-2013 has pushed the weight and GA limit upwards for sick babies !

Babies with weight 1.5kg to 2 kg with "unstable clinical course, including those requiring cardiorespiratory support and who are believed by their attending pediatrician or neonatologist to be at high risk for ROP"......do ROP screen

AAP-2013 has pushed the weight and GA limit upwards for sick babies !

Babies with weight 1.5kg to 2 kg with "unstable clinical course, including those requiring cardiorespiratory support and who are believed by their attending pediatrician or neonatologist to be at high risk for ROP"......do ROP screen

I noted that as well.

I have not read the references but are how are data backing that statement?

Infants up to 2 kg could be interpreted as if sick infants (in level-3-intensive care) with gest ages up to 34-35 weeks (for whatever reason) should be ROP screened.

Interesting point. There is no explanation nor citation though in the recommendation.

Here is what I found so far on the subject:

http://bjo.bmj.com/content/86/10/1127.short

Of the eligible infants surviving 28 days, 276 (91.7%) of 301 infants with birth weights ≤1500 g and 162 (52.3%) of 310 infants with birth weights between 1501 and 2500 g were screened for ROP. 10 (3.9%) of the 310 infants with larger birth weights developed stage 1 or 2 ROP. Two (0.6%) of the 310 infants with larger birth weights developed stage 3 ROP. These two infants progressed to threshold ROP and required treatment.

http://www.ncbi.nlm.nih.gov/pubmed/9651410

This probably was before the last recommendation was published, arguing that no cases of severe ROP would be missed if cut-off for gestational age or birth weight would be lowered

http://www.ncbi.nlm.nih.gov/pubmed/23644237

Conclusion: The majority of patients with BW greater than 1500 g developed mild ROP. However, advanced ROP with poor visual outcome was also encountered in some patients.

I wonder what our ophthalmologist colleagues will think if we start sending them 2 kg babies for ROP screen ?