Lower birthweight criterion suggested for ROP screenings

Chicago-A birthweight of 1,250 g may be a dependable criterion for screening for retinopathy of prematurity (ROP) and also might reduce the number of examinations, suggested Shailesh K. Gupta, MD, University of Florida College of Medicine, Jacksonville. Current guidelines recommend screening of infants under 1,500 g or a gestational age of less than 28 weeks.

Dr. Gupta based this conclusion on a retrospective study of 208 infants screened for ROP over a period of 2 years at a large academic medical center. The infants were divided into group 1 (n = 158), whose birthweight was less than or equal to 1,250 g, and group 2 (n = 50), whose birthweight was more than 1,250 g. The mean gestational age of infants in group 1 was 26.8 weeks; it was 30 weeks in group 2. Investigators found 116 eyes with ROP in group 1 and one case in one eye in group 2.

They analyzed numerous factors, including the maximum stage of ROP, and calculated sensitivity, specificity, and positive predictive value.

“The advantage of decreasing screening criteria to 1,250 g is that it increases the efficiency of ROP screenings. In our data set, it decreased screenings by 24% and decreased the expense,” Dr. Gupta said. He noted that multicenter studies of this hypothesis are needed and that future analyses need to take into account the racial and ethnic backgrounds of the infants.