Comparison of UK and US screening criteria for detection of retinopathy of prematurity in a developing nation

• Published in: Journal of AAPOS Vol. 14; no. 6; pp. 506 - 510
• Main Authors: Ugurbas, Silay Canturk, MD, Gulcan, Hande, MD, Canan, Handan, MD, Ankarali, Handan, MD, Torer, Birgin, MD, Akova, Yonca Aydn, MD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.12.2010
• Subjects: Developed Countries - statistics & numerical data; Female; Humans; Incidence; Infant, Newborn; Male; Ophthalmology; Practice Guidelines as Topic; Retinopathy of Prematurity - diagnosis; Retinopathy of Prematurity - epidemiology; Risk Factors; Turkey - epidemiology; United Kingdom; United States; Urban Population - statistics & numerical data; Vision Screening - methods; Vision Screening - standards
• ISSN: 1091-8531; 1528-3933
• DOI: 10.1016/j.jaapos.2010.07.012

Purpose To determine the incidence, risk factors, and appropriateness of differing guidelines in developed nations for screening for retinopathy of prematurity (ROP) in a single nursery in a large urban city in southern Turkey. Methods The records of 260 premature infants born ≤34 weeks in a single tertiary unit were retrospectively reviewed for ROP risk factors and diagnosis. Applicability of UK and US criteria were assessed by the use of receiver operating characteristic curves. Results ROP of any stage was present in 60 infants (23%); ROP requiring treatment was seen in 30 (11.5%). Univariate analysis showed a significant relationship among the following factors: gestational age, birth weight, total duration of supplemental oxygen, duration of mechanical ventilation, respiratory distress syndrome, anemia, and intraventricular hemorrhage ( p  < 0.0001). Multiple logistic regression analysis showed gestational age ( p = 0.039), birth weight ( p = 0.05), respiratory distress syndrome ( p = 0.05), and anemia ( p = 0.004) as independent predictors of ROP requiring treatment. Area under curve for gestational age alone for diagnosing stage 2 or greater ROP was 0.824 ± 0.03 ( p = 0.0001) and for birth weight alone was 0.808 ± 0.03 ( p = 0.0001). UK screening criteria detected all stage 2 and greater ROP; US screening criteria missed 2 infants with stage 2 ROP but detected all treatment-requiring disease. Adoption of these screening criteria would have reduced unnecessary examinations by either 21% (UK) or 37% (US). Conclusions UK and US criteria improved the detection accuracy for ROP requiring treatment in Turkey and should be studied for other developing nations.