Early ROP screening urged for extremely premature infants, study finds

Extremely premature infants, particularly those born before 24 weeks’ gestational age, are at significantly higher risk for developing severe retinopathy of prematurity (ROP) early in their postnatal life, according to a study that underscores the importance of initiating ROP screening examinations well before 31 weeks’ postmenstrual age (PMA) to detect and manage ROP progression promptly.

The study, comparing outcomes between infants born at 24-30 weeks’ gestational age (GA) and those born before 24 weeks’ GA (N = 2061), found significant differences in the prevalence and progression of ROP. Infants born at less than 24 weeks’ GA were notably more likely to develop severe forms of ROP, including pre-plus and plus disease, and required treatment earlier compared to those born at 24-30 weeks’ GA.

The study found that 8 infants developed pre-plus or greater severity ROP before 31 weeks’ PMA, with the majority (6 out of 8) born before 24 weeks’ GA. In addition, 3 infants developed plus disease or required treatment before 31 weeks’ PMA, with the earliest case identified at 27 and 3/7 weeks.

The findings suggest a potential shift in current screening practices, urging early vigilance and monitoring for ROP in extremely premature infants to mitigate severe visual impairments later in life.

Reference
Souverein EA, Siegel BA, Siegel LM, et al. Initiation of retinopathy of prematurity screening examinations in extremely premature infants. J AAPOS. 2024;103956. doi: 10.1016/j.jaapos.2024.103956. Epub ahead of print. PMID: 38878959.