Results of a program for the prevention of blindness caused by retinopathy of prematurity in southern Brazil.
OBJECTIVE
To describe the results of a program for the prevention of blindness caused by retinopathy of prematurity implemented in 2002 at a tertiary-care hospital, according to screening criteria adopted in Brazil, and to compare some aspects with the criteria adopted by other countries.


METHODS
Descriptive observational study including all preterm infants born at this hospital weighing <or= 1,500 g at birth and/or gestational age <or= 32 weeks who survived up to the sixth week after birth, between October 2002 and June 2006. Ophthalmic examinations were performed from the sixth week of life and repeated as necessary until remission of the disease.


RESULTS
A total of 300 newborns were included and there were 18 cases of treatable threshold disease (18/300, 6%) according to the Brazilian criteria. One patient was not treated because s/he developed the disease after hospital discharge and did not turn up for examination in order to initiate treatment. According to the criteria suggested by industrialized countries, the total number of exams would be reduced under the same circumstances, but 11.76% of the cases of threshold disease would not be detected.


CONCLUSIONS
The Brazilian criteria for neonatal screening were efficient in detecting treatable cases. Blindness was averted in 17 preterm infants in the study period. The universal use of such program at teaching hospitals or in the public and private health networks could help prevent one of the main causes of preventable and treatable blindness among infants in developing countries. Currently, a change in these criteria in Brazil may compromise the diagnosis of some treatable patients.
Fortes Filho
João Borges
JB
Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. jbfortes@cursohbo.com.br
Barros
Cristiano Koch
CK
da Costa
Marlene Coelho
MC
Procianoy
Renato S
RS
D001766:Blindness / Q000209:etiology / Q000517:prevention & control*; D001938:Brazil; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015997:Neonatal Screening / Q000379:methods* / Q000592:standards; D010043:Outcome and Process Assessment, Health Care; D015397:Program Evaluation; D012178:Retinopathy of Prematurity / Q000150:complications / Q000175:diagnosis*; D012307:Risk Factors