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International Journal of Pediatrics
Volume 2017, Article ID 9372539, 8 pages
Research Article

Can a Risk Factor Based Approach Safely Reduce Screening for Retinopathy of Prematurity?

1College of Nursing, University of Utah, Salt Lake City, UT, USA
2School of Medicine, Division of Neonatology, University of Utah, Salt Lake City, UT, USA
3School of Medicine, Department of Ophthalmology, University of Utah, Salt Lake City, UT, USA
4Intermountain Health Care, Institute for Health Care Delivery Research, Salt Lake City, UT, USA

Correspondence should be addressed to R. J. DiGeronimo; ten.tsacmoc@5ominoregid

Received 19 July 2016; Revised 18 October 2016; Accepted 13 November 2016; Published 9 January 2017

Academic Editor: Naveed Hussain

Copyright © 2017 K. M. Friddle et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. Current American retinopathy of prematurity (ROP) screening guidelines is imprecise for infants ≥ 30 weeks with birth weights between 1500 and 2000 g. Our objective was to evaluate a risk factor based approach for screening premature infants at low risk for severe ROP. Study Design. We performed a 13-year review from Intermountain Health Care (IHC) data. All neonates born at ≤32 weeks were reviewed to determine ROP screening and/or development of severe ROP. Severe ROP was defined by stage ≥ 3 or need for laser therapy. Regression analysis was used to identify significant risk factors for severe ROP. Results. We identified 4607 neonates ≤ 32 weeks gestation. Following exclusion for death, with no retinal exam or incomplete data, 2791 (61%) were included in the study. Overall, severe ROP occurred in 260 (9.3%), but only 11/1601 ≥ 29 weeks (0.7%). All infants with severe ROP ≥ 29 weeks had at least 2 identified ROP risk factors. Implementation of this risk based screening strategy to the IHC population over the timeline of this study would have eliminated screening in 21% (343/1601) of the screened population. Conclusions. Limiting ROP screening for infants ≥ 29 and ≤ 32 weeks to only those with clinical risk factors could significantly reduce screening exams while identifying all infants with severe ROP.