Evaluation and modification of French screening guidelines for retinopathy of prematurity

Purpose To evaluate the current French screening guidelines for retinopathy of prematurity (ROP) and to suggest modifications to it. Methods In this multicentric retrospective, noncomparative, interventional case series we included infants with a gestational age (GA) <= 32 weeks who were screened for ROP by fundus examination between 2011 and 2018. Main Outcome Measures were the presence of ROP and the need for treatment. Results A total of 2246 children with a mean GA of 28.9 +/- 2.0 weeks and mean birth weight (BW) of 1141.1 +/- 332.0 g were screened. Retinopathy of prematurity (ROP) was found in 683 infants (30.4%), of whom 145 (6.5%) had type 2 ROP and 58 (2.6%) had type 1 ROP. Mean GA of infants with type 1 ROP needing treatment was 25.9 + 1.5 weeks (range: 23.6-30) and mean BW was 774.1 +/- 173.7 g (range: 540-1400). Both GA and BW had an impact on the development of type 1 and 2 ROP. None of the infants needing treatment had a GA of 31 weeks or more. None of the children needed treatment before 33 weeks of postmenstrual age (PMA) or 6 weeks of postnatal age (PNA). Conclusion It seems possible to decrease the screening of premature infants to <= 31 weeks of GA and to start screening at 31 weeks PMA for infants having a GA < 26 weeks and at 6 weeks PNA for more mature children.