title: Evaluating retinopathy of prematurity screening guidelines for 24- to 27-week gestational age infants.
abstract: OBJECTIVE
  To determine whether current retinopathy of prematurity (ROP) screening guidelines adequately identify treatable ROP in a contemporary cohort of extremely low gestation infants.
  
  
  METHODS
  Data from the Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial were used. Inborn infants of 24 (0)/7 to 27 (6)/7 weeks gestational age (GA) with consent before delivery were enrolled in 2005 to 2009. Severe ROP (type 1 ROP or treatment with laser, cryotherapy or bevacizumab) or death was the primary outcome for the randomized trial. Examinations followed the then current AAP (American Academy of Pediatrics) screening recommendations, beginning by 31 to 33 weeks postmenstrual age (PMA).
  
  
  RESULTS
  One thousand three hundred and sixteen infants were enrolled in the trial. Nine hundred and ninety-seven of the 1121 who survived to first eye exam had final ROP outcome determined. One hundred and thirty-seven (14% of 997) met criteria for severe ROP and 128 (93%) of those had sufficient data (without missing or delayed exams) to determine age of onset of severe ROP. PMA at onset was 32.1 to 53.1 weeks. In this referral center cohort, 1.4% (14/997) developed severe ROP after discharge.
  
  
  CONCLUSIONS
  Our contemporary data support the 2013 AAP screening guidelines for ROP for infants of 24 (0)/7 to 27 (6)/7 weeks GA. Some infants do not meet treatment criteria until after discharge home. Post-discharge follow-up of infants who are still at risk for severe ROP is crucial for timely detection and treatment.
authors: Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX, USA.
authors: K A
authors: KA
authors: Kennedy
authors: Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC, USA.
authors: L A
authors: LA
authors: Wrage
authors: Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors: R D
authors: RD
authors: Higgins
authors: Department of Pediatrics, University of California at San Diego, San Diego, CA, USA.
authors: N N
authors: NN
authors: Finer
authors: Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: W A
authors: WA
authors: Carlo
authors: Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
authors: M C
authors: MC
authors: Walsh
authors: Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI, USA.
authors: A R
authors: AR
authors: Laptook
authors: Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors: R G
authors: RG
authors: Faix
authors: Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors: B A
authors: BA
authors: Yoder
authors: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH, USA.
authors: K
authors: K
authors: Schibler
authors: Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, NC, USA.
authors: M G
authors: MG
authors: Gantz
authors: Biostatistics and Epidemiology Division, RTI International, Rockville, MD, USA.
authors: A
authors: A
authors: Das
authors: Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.
authors: N S
authors: NS
authors: Newman
authors: Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
authors: D L
authors: DL
authors: Phelps
mesh_terms: D005260:Female; D006801:Humans; D007234:Infant, Premature; D008297:Male; D017410:Practice Guidelines as Topic; D012178:Retinopathy of Prematurity / Q000175:diagnosis*