Timely compliance to the first ROP screening evaluation is associated with better final retinal outcomes

Abstract Background/purpose The purpose of this project is to evaluate the adherence of clinical practices to the National OSP (Ophthalmological Society of Pakistan) guidelines for the timing of the first ROP screening and to assess the impact of the timely presentation of premature babies on eventual retinal outcomes and the necessity for treatment. Methods We conducted this study on 270 neonates to evaluate adherence to the OSP guidelines for the timing of the first ROP screening examination and to assess its impact on the need of treatment and final retinal outcomes. These 270 newborns met the screening criteria of OSP (Gestational Age ≤ 35 weeks or Birthweight ≤ 2000 g) and were categorized into the Compliant and Non-Compliant Groups, depending upon their first examination within or after 4 weeks from birth. Outcomes were Normal Vascularization, Any ROP, Type 1 ROP, Lost to follow-up, and Retinal Detachment (Stage 4a or worse). Results There were 54.1% and 45.9% neonates in Compliant and Non-compliant groups, respectively. A highly significant difference in chronological age was observed between the two groups ( p < 0.001). There were significantly more patients with Any ROP in the Compliant group (15%) as compared to the Non-Compliant (3%) ( p = 0.001). Normal vascularization and type 1 ROP were approximately comparable in both groups. A total of 48 patients were lost to follow-up. Patients in the Compliant group had all infants with retina attached as the outcome, while the Non-Compliant group had a significantly worse outcome, with retinal detachment occurring in 8.1% of patients ( p < 0.001). Out of these, 1 (1.27%) neonate presented at 5–8 weeks, 3 (9.09%) at 9–16 weeks, and 6 (50.0%) after 16 weeks. Conclusions As most exams are done on outpatients, our paper highlights the importance of good coordination between Neonatal ICUs and Ophthalmology services for critical first-time eye examinations.