A practical method for reducing blindness due to retinopathy of prematurity in a developing country

Background: Retinopathy of prematurity (ROP) is a common cause of blindness in countries with rapidly developing systems of neonatal care. At present, detection and treatment programs are not widely available in many regions of middle-and low-income countries. Subject population: Case series. Methods: An analysis was undertaken to determine in which neonatal intensive care units (NICUs) in Peru babies blind from ROP had been cared for. Demographic and hospital information was gathered for children blind from ROP presenting before the age of 5 years. NICUs with a high likelihood of having ROP-blind children were offered training and equipment designed to improve neonatal care. Results: Ninety-one children with ROP blindness were identified. Twenty-six percent were <1000 g at birth, and 17% had birth weights of >1500 g. Forty-six percent came from NICUs in Lima. Interventional workshops emphasizing neonatal care and oxygen administration have been conducted thus far in six of the 13 largest NICUs in Lima. The percentage of at-risk babies being examined has generally increased, whereas the percentage of babies requiring treatment decreased in three NICUs and increased slightly in two, and no preworkshop data were available in one. Conclusion: This report represents the initial results of an evidence-based approach to decreasing blindness from ROP in Peru. Workshops emphasizing neonatal care, especially targeting oxygen administration, provide methods for improving care of at-risk babies.