Retinopathy of prematurity screening: can the examination time be reduced?

Abstract

Clinical relevance: Retinopathy of prematurity (ROP) is a significant cause of childhood blindness. Screening examinations that maintain accuracy, while improving the experience for families, could increase adherence to follow-up and decrease workload.

Background: Traditional ROP screening examinations are known to be uncomfortable for babies and stressful for parents. A new strategy is proposed and tested for the accuracy of the outcome and the time taken.

Methods: In this new screening strategy, the examiner performs a complete retinal examination on the first visit. If the area and stage of the nasal and temporal retinal regions are similar or the stage of the temporal half is worse, only the posterior pole and temporal half of the retina are evaluated at subsequent visits. A retrospective patient file review was conducted to compare the new proposal with accepted methods. ROP examination time was compared prospectively.

Results: The data of 57 consecutive patients treated for ROP were evaluated. The ROP zone was the same in the nasal and temporal retina in all eyes at the first and last visit before treatment. Only two eyes had worse ROP stage in the nasal half at presentation but both halves developed the same degree of stage during follow-up. None of the treatment decisions were based only on the nasal region of the retina. Examination time was evaluated in 40 eyes of 20 infants. The average total time required for an examination with the accepted method was 241.3 ± 112.5 seconds. However, with the proposed strategy, the examination time was significantly reduced to 172.3 ± 69.2 seconds (p < 0.001).

Conclusions: This screening strategy shortens examination time, which may help reduce pain and related adverse events.

Keywords: Indirect ophthalmoscopy; patient comfort; retinopathy of prematurity; screening; strategy; time.