Posted May 11, 201311 yr 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 ?
May 12, 201311 yr 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)
May 13, 201311 yr Author 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
May 14, 201311 yr 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.
May 16, 201311 yr 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.
May 16, 201311 yr Author I wonder what our ophthalmologist colleagues will think if we start sending them 2 kg babies for ROP screen ?
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