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Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study
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  • Published on: 23 November 2020
    Letter: Optimised retinopathy of prematurity screening guideline in China
    • Liang Wang, Ophthalmologist Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University
    • Other Contributors:
      • Zifeng Zhang, Ophthalmologist
      • Manhong Li, Ophthalmologist
      • Yusheng Wang, Ophthalmologist

    We were intrigued by the study by Yang et al[1] recently published in the British Journal of Ophthalmology. They conducted a detailed analysis of the fundus screening results of 5606 infants over 5 years in tertiary neonatal intensive care units (NICUs) in four medical centres in Shanghai, China. They found the detection rate of retinopathy of prematurity (ROP)to be 15.9%, and the detection rate of type 1 ROP (1.1%) was lower than that previously reported. The mean gestational age (GA) and birth weight (BW) of infants with ROP have also decreased. Therefore, they suggest modifying the criteria of Chinese ROP screening to GA <32 weeks or BW <1600 g. Application of these criteria to the studied cohort yielded a 98.4% sensitivity, with the infants requiring fundus screening reduced by 43.2%. Therefore, these criteria would reduce medical costs significantly. This is of great significance to the screening and treatment of ROP in China, which has a huge population and regional medical resource imbalances.
    However, the study also had issues that need further discussion. First, the patient cohort was not a continuous population-based cohort, and the authors did not clearly state the specific criteria for screening. Therefore, the rate could be the detection rate rather than the true incidence. In addition, the development and general conditions of these patients from NICUs are significantly different from those of the general population. Therefore, although it was a r...

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    Conflict of Interest:
    None declared.