Retinopathy of Prematurity: An Example of a Successful Screening Program

2010 ◽  
Vol 29 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Wendy VanStone
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Multidisciplinary Approach ◽  
Screening Program ◽  
Low Birth Weight Infants ◽  
Parental Compliance ◽  
American Academy Of Pediatrics ◽  
Rop Screening

Retinopathy of prematurity (ROP) is a persistent and often devastating morbidity associated with premature and low birth weight infants. It continues to be a frequent diagnosis in the neonatal intensive care unit, despite technologic advances and increased knowledge. The American Academy of Pediatrics (AAP) has issued practice guideline recommendations for ROP screening and treatment that aid in creating a consistent and reliable ROP protocol. Challenges exist in screening for and treating ROP, including delayed or omitted exams, lack of qualified examiners, lack of parental compliance with follow-up care, and fear of litigation. This article provides a detailed example of a successful ROP program based on the AAP recommendations and utilizing a multidisciplinary approach to ensure optimal ROP care for the preterm infant. It also discusses the role of the ROP coordinator assigned to the NICU.

Retinopathy of Prematurity—Using Electronic Medical Records to Efficiently Follow Patients at Multiple Hospitals

2021 ◽  
pp. 097321792110076
Author(s):  
Gwendolyn Schultz ◽  
Majida Gaffar
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Transitional Period ◽  
Neonatal Intensive Care Units ◽  
American Academy Of Pediatrics ◽  
Time Period ◽  
Cost Efficient ◽  
Delay Of Care ◽  
Physician Scheduling ◽  
Rop Screening

Purpose: To report the use of a centralized electronic medical record (EMR) to provide timely retinopathy of prematurity (ROP) screening in a previously fragmented monitoring system in a standalone children’s hospital in Connecticut. Methods: A chart review of 306 visits for ROP screening in 3 neonatal intensive care units (NICUs) over a time period of 24 months. Results: All infants born at <30 weeks gestational age or birth weight <1,500g (N = 107) at these NICUs were screened for ROP according to the American Academy of Pediatrics guidelines. Data was collected before the implementation of our centralized EMR list, during a transitional period, and once the list was established. Our analysis of the data found an improvement in delay of care from 16.85% to 10.83% of visits, and a decrease in number of visits done during off hours from 20.4% to 5% of visits. Conclusion: Our tool was a free and cost-efficient centralization of a once difficult-to-manage process for ROP screenings in Connecticut. The decrease in delay of care and improvement in physician scheduling will lead to better outcomes for our patients and better sustainability of practice for our providers.

scholarly journals Retinopathy of Prematurity: Clinical Diagnosis and Classification.

2018 ◽  
pp. 21-28
Keyword(s):  
Retinopathy Of Prematurity ◽  
Treatment Process ◽  
Very Low Birth Weight ◽  
Screening Program ◽  
World Health ◽  
Vision 2020 ◽  
Low Birth Weight Infants ◽  
Diagnosis And Classification ◽  
Health Organization

Retinopathy of prematurity (ROP) is an important and preventable cause of childhood blindness. For this reason, in the VISION 2020 program initiated by the World Health Organization to eliminate avoidable blindness, the control of the disease was highlighted. As the survival rate of very low birth weight infants increases in developing countries, including our country, due to improvements in neonatal care, the frequency of the disease has increased. The basic strategy for the prevention of blindness from ROP is to identify the patients requiring treatment by examining them according to a certain protocol. In this process, also called the Screening program, it is important to identify as many babies needing treatment as possible while minimizing the number of examinations. In this respect, the risk group should be well- defined, and diagnosis, follow-up, and treatment process should be done in line with a standard protocol. This review aims to give information about the diagnosis, follow-up, and treatment of ROP.

scholarly journals Pitfalls in Retinopathy of Prematurity Screening: A Qualitative Content Analysis

2021 ◽  
Author(s):  
lojain Albathi ◽  
Nourah Abouammoh ◽  
Naif Alsowaina ◽  
Hani Albalawi ◽  
Abdullah Alqahtani ◽  
...  
Keyword(s):  
Content Analysis ◽  
Retinopathy Of Prematurity ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Qualitative Content Analysis ◽  
Surgical Care ◽  
Screening Guidelines ◽  
Delayed Referral ◽  
Rop Screening

Abstract Purpose: To identify the pitfalls in retinopathy of prematurity (ROP) screening leading to advanced disease at Ministry of Health (MOH) hospitals in Saudi Arabia. Methods: A qualitative deductive content analysis was used to study the phenomena of defects in ROP screening. A retrospective review of medical records of newborns presenting to two tertiary eye care centers with advanced ROP (Stage 4 and 5) from January 2012 to June 2019 was completed. An extensive review of the original files at the referring hospitals was conducted, including the general condition and findings of ophthalmic examination and the sequence of follow-up until the infant was discharged/referred. Data analysis was completed using pre-structured categorization matrix. Results: Records of 29 infants with advanced stage ROP were identified. Only 13 medical records were available and obtained. The pitfalls in screening found in the study were failure to refer by the neonatologist, delayed follow-up by the ophthalmologist, failure to follow-up by the ophthalmologist, failure to diagnose by the ophthalmologist, poor documentation in patient files, unavailability of ophthalmologist, family negligence, lack of treatment and delayed referral to a higher center, and progression despite timely screening and management.Conclusion: Although clear ROP screening guidelines are available, implementations of these guidelines are suboptimal. This study showed the most common defect in screening is physician’s inadequacy and unavailability. A proper network of competent ROP screening physicians in all neonatal intensive care units should be established. Centers for advanced ROP surgery should be allocated to deliver a timely surgical care if needed.

Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study

2020 ◽  
pp. bjophthalmol-2020-316401
Author(s):  
Qian Yang ◽  
Xiaohong Zhou ◽  
Yingqin Ni ◽  
Haidong Shan ◽  
Wenjing Shi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Predictive Performance ◽  
Screening Guideline ◽  
Postmenstrual Age ◽  
The Mean ◽  
Type 1 Rop ◽  
Rop Screening

PurposesTo develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).MethodsA multicentre retrospective cohort study was conducted based on data from four tertiary neonatal intensive care units in Shanghai, China. The medical records of enrolled infants, born from 2012 to 2016 who underwent ROP examinations, were collected and analysed. The incidence and risk factors for ROP were analysed in all infants. Postnatal age (PNA) and postmenstrual age (PMA) of infants, detected to diagnose ROP for the first time, were compared with the present examination schedule. The predictive performance of screening models was evaluated by internally validating sensitivity and specificity.ResultsOf the 5606 eligible infants, ROP was diagnosed in 892 (15.9%) infants; 63 (1.1%) of them received treatment. The mean GA of ROP patients was 29.4±2.4 weeks, and the mean BW was 1260±330 g. Greater prematurity was associated with an older PNA at which ROP developed. The minimum PMA and PNA at which diagnosis of treatable ROP occurred were 32.43 and 3 weeks, respectively. The optimised criteria (GA <32 weeks or BW <1600 g) correctly predicted 98.4% type 1 ROP infants, reducing the infants requiring examinations by 43.2% when internally validated.ConclusionsThe incidence of type 1 ROP and the mean GA and BW of ROP infants have decreased in China. The suggested screening threshold and schedule may be reliably used to guide the modification of ROP screening guideline and decrease medical costs.

scholarly journals A Prospective Study on Retinopathy of Prematurity in a Teritiary Care Center

2020 ◽  
Vol 8 (1) ◽  
pp. 58-60
Author(s):  
Mahaboob Basha Kallur ◽  
K. Muralidhar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Care Center ◽  
Low Birth Weight Infants ◽  
Cross Sectional ◽  
Retinal Neovascularisation ◽  
Premature Babies ◽  
Low Birth Weight Babies

Background: Retinopathy of prematurity (ROP) is a vaso-proliferative retinopathy which occurs mostly in premature babies. The pathological change in ROP is peripheral retinal neovascularisation which may regress completely or leave sequelae from mild myopia to bilateral total blindness. International classification of ROP helped in uniform documentation and staging of ROP. In India, the incidence of ROP is between 38 and 51.9 p.c among low-birth-weight infants. Aim & Objectives: To estimate the incidence of ROP among premature and / or low birth weight babies who were born and admitted to neonatal intensive care unit and attending neonatal follow-up clinic.Subjects and Methods:A hospital based, prospective analytical cross-sectional study was conducted in Department of Pediatrics at Shadan Institute of Medical Sciences, Teaching hospital and research center, Hyderabad, Telangana for a period of 6 months from 1st October 2018 to 31st March 2019. Prior to the study initiation, ethical clearance was obtained and written consent was taken from the parents of the respective babies. The study subjects included premature babies (less than or equal to 35 weeks of gestation) or low birth weight babies (less than or equal to 1500 grams). A predesigned, pre-tested, semi-structured proforma was used to collected the data. The data was collected, entered in Microsoft excel-2013 and analyzed using SPSS version-22 (trial). Data was presented in percentages, proportions and figures.Result:The ROP incidence in the study group was reported among 17.1 p.c of the study subjects.Conclusion:Low birth weight and prematurity are important risk factors for ROP.

scholarly journals A Qualitative Analysis of Challenges and Successes in Retinopathy of Prematurity Screening

2018 ◽  
Vol 08 (02) ◽  
pp. e128-e133 ◽  
Author(s):  
Lisa Bain ◽  
Alexandria Kristensen-Cabrera ◽  
Henry Lee
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Thematic Analysis ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Quality Care ◽  
Common Theme ◽  
Key Factors ◽  
Culture Education ◽  
Rop Screening

Objective The objective of this study is to identify characteristics of neonatal intensive care unit (NICU) practice that influence successful retinopathy of prematurity (ROP) screening. Study Design In this qualitative study, top, improved, and bottom performing NICUs in the California Perinatal Quality Care Collaborative were identified based on ROP screening rates and invited to participate. NICU personnel were interviewed using a semistructured questionnaire. Using thematic analysis, key factors that influence ROP screening were identified. Results Themes found in top performing hospitals include a commitment to quality improvement, a committed ophthalmologist, and a system of double checks. Improved NICUs had a common theme of utilizing telemedicine for exams and identification of eligible neonates on admission. The bottom performing hospital struggled with education and identification of eligible neonates and a lack of a dedicated ophthalmologist. Conclusion Structure, culture, education, and commitment all contribute to the success of ROP screening in the NICU.

Follow-up of NICU Graduates: Why, What, and by Whom

1995 ◽  
Vol 10 (5) ◽  
pp. 213-225 ◽  
Author(s):  
Marie C. Mccormick ◽  
Jane E. Stewart ◽  
Robyn Cohen ◽  
Marsha Joselaw ◽  
Priscilla S. Osborne ◽  
...  
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Data Collection ◽  
Low Birth Weight ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Collection Strategies

Follow-up of the graduates of neonatal intensive care is an important component of the provision of such care. However, the objectives of these programs and their data-collection strategies vary widely. This report describes the potential objectives and different data-collection strategies. It then reviews briefly what is known about the outcomes of very low birth weight infants to guide the development of assessment packets: Finally, we describe the operation of our program and activities of our team to illustrate the follow-up experience in a large multi-institution program.

scholarly journals Peripheral optical coherence tomography assisted by scleral depression in retinopathy of prematurity

2021 ◽  
Author(s):  
Brittni A. Scruggs ◽  
Shuibin Ni ◽  
Thanh-Tin P. Nguyen ◽  
Susan Ostmo ◽  
Michael F. Chiang ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Peripheral Retina ◽  
Optical Coherence ◽  
Rapid Acquisition ◽  
Study Participants ◽  
Rop Screening

Objective: To determine whether handheld widefield optical coherence tomography (OCT) can be used to document retinopathy of prematurity (ROP) stage while using scleral depression to improve peripheral views. Design: Prospective observational study. Participants: Consecutive neonates admitted to the neonatal intensive care unit (NICU) in a single academic medical center who also met criteria for ROP screening and consented for research imaging. Methods: Scleral depression was combined with widefield OCT using an investigational 400-kHz, 55-degree field of view handheld OCT during ROP screening from October 28, 2020 to March 03, 2021. Main Outcome Measures: Acquisition of en face and B-scan imaging of the peripheral retina to objectively assess early vitreoretinal pathology, including the demarcation between vascularized and anterior avascular retina, the presence of early ridge formation, and small neovascular tufts. Results: Various stages of ROP were detected using a rapid acquisition OCT system. In one neonate, serial OCT imaging over a five-week period demonstrated accumulation of neovascular tufts with progression to stage 3 ROP with extraretinal fibrovascular proliferation along the ridge. Videography of this technique is included in this report for instructional purposes. Conclusions: Serial examinations using widefield OCT and scleral depression may improve detection and documentation of ROP disease progression. Earlier detection of ROP-related proliferation may prevent vitreoretinal traction, retinal detachment, and blindness.

scholarly journals Retinopathy of Prematurity – Bangladesh perspective

2021 ◽  
Vol 11 (2) ◽  
pp. 447-452
Author(s):  
Maksudur Rahman ◽  
Liton Chandra Saha ◽  
Md Mahbubul Hoque ◽  
M Monir Hossain ◽  
BH Nazma Yasmeen
Keyword(s):  
Developing Countries ◽  
Visual Impairment ◽  
Preterm Infants ◽  
Functional Impairment ◽  
Retinopathy Of Prematurity ◽  
Screening Program ◽  
Capital City ◽  
Medical College ◽  
Timely Referral ◽  
Rop Screening

Retinopathy of Prematurity (ROP) results in severe visual impairment and blindness in newborns. Now a days with the advancement of the technology to save preterm infants, its incidence is also increasing in both developed and developing countries. Appropriate and timely screening program can prevent ROP and reduces the functional impairment of eyes. Many countries have their guideline for ROP screening. Bangladesh national guideline is still in progress. Hope it will be published soon. In Bangladesh practically nationwide ROP screening was started in 2013. But still most of the screening program is limited to the capital city. Vast majority of neonates who stayed in peripheral districts are still out of screening program and failed to have timely referral. The current efforts of screening program are mainly driven by the private, NGO and the Gov’t professional bodies. Northern International Medical College Journal Vol.11 (2) Jan 2020: 447- 452

Sign in / Sign up

Export Citation Format

Share Document