County Durham and Darlington NHS Foundation Trust, Darlington, UK.
Royal Hospital for Children, NHS Greater Glasgow and Clyde, Glasgow, UK.
Eye (Lond). 2024 Sep;38(13):2557-2560. doi: 10.1038/s41433-024-03076-3. Epub 2024 Apr 24.
BACKGROUND/OBJECTIVES: Screening for retinopathy of prematurity (ROP) is a core healthcare intervention in premature babies to avoid preventable sight loss. A variety of screening criteria are in place globally for this purpose. The Royal College of Paediatrics and Child Health recently updated the United Kingdom ROP screening guidelines (March 2022). A key change was the reduction in the gestational age (GA) to warrant retinal screening (from 32 to 31 weeks).
SUBJECTS/METHODS: In the course of informal national surveillance during guideline development (2017-2022) and soon after, babies under our care falling outside the updated screening criteria who underwent treatment for ROP were identified. A retrospective case review was carried out.
Six babies were identified as having undergone screening and treatment, prior to implementation of the new guidance. Screening and treatment would have been forfeited as per the March 2022 guidelines. All six had numerous systemic risk factors for developing ROP. Specifically, all had documented poor postnatal weight gain.
We present this case series to bring forth an urgent discussion amongst key stakeholders as to whether the new guidance, as it stands, is safe and fit for purpose.
背景/目的:早产儿视网膜病变(ROP)筛查是早产儿避免可预防视力丧失的核心医疗干预措施。为此,全球范围内制定了各种筛查标准。皇家儿科学会最近更新了英国 ROP 筛查指南(2022 年 3 月)。一个关键的变化是降低了需要视网膜筛查的胎龄(GA)(从 32 周降至 31 周)。
受试者/方法:在指南制定期间(2017-2022 年)以及之后不久,我们在进行非正式的国家监测时,发现了一些在我们照护下的婴儿不符合更新后的筛查标准,但接受了 ROP 治疗。对这些婴儿进行了回顾性病例分析。
有 6 名婴儿在新指南实施前接受了筛查和治疗。根据 2022 年 3 月的指南,这些筛查和治疗本应被放弃。这 6 名婴儿都有发生 ROP 的多种系统性危险因素。具体来说,所有婴儿的出生后体重增长都明显不良。
我们提出这个病例系列,是为了在主要利益相关者之间紧急讨论新指南是否安全和适用。