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Further measures are needed to help avert the risk of lifelong blindness in preterm babies, the first population study of severe retinopathy of prematurity (ROP) has found.
Fourteen preterm babies, out of 233 studied, developed lifelong blindness from severe ROP in one eye or both, some as a result of deficiencies in screening or treatment. The UK multicentre study also found that screening on the basis of gestational age and birth weight together, not singly, captured outliers in the study and potentially brought the screening criteria down to <29 weeks’ gestational age and <1250 g birth weight, from current UK criteria of ⩽31 weeks and ⩽1500 g, respectively.
The review during 1997–9 found that national screening guidelines were followed in 72% of cases, but in 28% screening was too late or too infrequent. Also in 13 babies progression of the condition indicated that severity had been wrongly judged. In three cases in which follow up data were available non-compliance with screening guidelines led to adverse sight at one year. Treatment was delayed longer than recommended in five babies. In most babies ROP was bilateral (84%) and most severe with lowest gestational age and birth weight.
Babies with stage 3 ROP or worse were identified through the surveillance unit of the Royal College of Ophthalmologists, and data on clinical condition, screening and treatment, and outcome at one year were recorded by questionnaire.
ROP, a fairly rare disease confined to preterm babies, is largely, but not entirely, preventable by timely identification and treatment.