title: Trends in the Screening and Treatment of Retinopathy of Prematurity.
abstract: To determine the current practice patterns of retinopathy of prematurity (ROP) screening and treatment and the attitudes toward new screening and treatment modalities in level III and level IV NICUs, as reported by medical directors.
  
  
  
  Surveys were mailed to the medical directors of 847 level III NICUs identified in the 2011 American Academy of Pediatrics directory in April 2015. In September 2015, responses were compared with American Academy of Pediatrics guidelines and previous reports. Within-sample comparisons were made by level, setting, size, and academic status.
  
  
  
  Respondents indicated that ROP screening is most often performed in their NICUs by pediatric and/or retina specialists (90%); retinal imaging devices are infrequently used (21%). Treatment is performed by pediatric (39%) and/or retina (57%) specialists in the NICU, usually under conscious sedation (60%). The most common treatment modality was laser photocoagulation (85%), followed by anti-vascular endothelial growth factor injection (20%). Some NICUs do not provide treatment services (28%), often due to a lack of ophthalmologists (78%). Respondents showed slightly more agreement (35%) than disagreement (25%) that a retinal imaging device could replace indirect ophthalmoscopy (40% were neutral). More respondents agreed than disagreed (30% vs 15%) that telemedicine for ROP screening is safe, but most were neutral (55%).
  
  
  
  Screening and treatment of ROP are not implemented uniformly in NICUs across the United States. Concerns regarding an insufficient ROP workforce are validated.
authors.affiliation: Departments of Pediatrics and Communicable Diseases, and rebeccav@med.umich.edu.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Vartanian
authors.affiliation: Ophthalmology and Visual Sciences, University of Michigan Health Systems, Ann Arbor, Michigan; and.
authors.forename: Cagri G
authors.initials: CG
authors.lastname: Besirli
authors.affiliation: Departments of Pediatrics and Communicable Diseases, and.
authors.forename: John D
authors.initials: JD
authors.lastname: Barks
authors.affiliation: Ophthalmology and Visual Sciences, University of Michigan Health Systems, Ann Arbor, Michigan; and.
authors.forename: Chris A
authors.initials: CA
authors.lastname: Andrews
authors.affiliation: Ophthalmology and Visual Sciences, University of Michigan Health Systems, Ann Arbor, Michigan; and.|Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.
authors.forename: David C
authors.initials: DC
authors.lastname: Musch
mesh_terms: D001291:Attitude of Health Personnel; D019983:Guideline Adherence / Q000639:trends; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D056965:Injections, Intraocular; D007363:Intensive Care Units, Neonatal; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D053685:Laser Therapy / Q000706:statistics & numerical data; D015997:Neonatal Screening / Q000639:trends*; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000628:therapy*; D042262:Retinoscopy; D014481:United States; D042461:Vascular Endothelial Growth Factor A / Q000009:adverse effects
chemical_list: D042461:Vascular Endothelial Growth Factor A