Choosing wisely babies for retinopathy of prematurity screening is more important in low resource setting

Design: A prospective observational study. Setting: The study was conducted over a period of one year, from 01-07-2013 to 30-06-2014 at a hospital attached to a newly established rural medical college in India; located 45 km away from the regional eye centre. Subjects: All babies, without exclusions, were screened for retinopathy of prematurity (ROP) as per guidelines of National Neonatology Forum (NNF) of India, i.e. babies born < 34 weeks gestation and/or < 1750 g birth weight, and the babies 34-36 6/7 weeks gestation or 1750-2000 g birth weight, with risk factors for ROP. Interventions: 53 babies were screened for ROP as per NNF guidelines. Main Outcome Measures: 16 babies required laser therapy from the 53 babies that were screened over a period of one year. All weighed 1500 g or less at birth. Their GA was less than 33 weeks or less. Conclusion: BW 1500 g or less and/ or GA less than 34 weeks, appear to be appropriate ROP screening criteria. Applying NNF criteria, no ROP would have been missed. In 19 (35.8%) babies screening could have been avoided. It is desirable to determine appropriate ROP screening criteria for a particular centre; based on local evidence.