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2025 ; 25
(1
): 594
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Severe ROP rate and assessment of the burden of ROP screening at a single
tertiary care public hospital in Pakistan
#MMPMID41131487
Moin M
; Mian LS
; Martinez-Hussain M
; Shahid M
; Gilbert C
; Mian UK
BMC Ophthalmol
2025[Oct]; 25
(1
): 594
PMID41131487
show ga
BACKGROUND: To assess the rate of severe ROP and the burden of examining preterm
infants requiring ROP screening. METHODS: A prospective study of all inborn
preterm infants eligible for ROP screening admitted to Lahore General Hospital
(LGH) between 2015 and 2021 with a gestational age (GA) of ??35 weeks or a
birthweight (BW) of ??2000 g. All infants had a dilated fundus exam, and the
number of examinations and level of ROP were recorded. RESULTS: 3,521 infants met
the screening criteria, 1,641 (46.7%) of whom were screened at least once. Among
the 1880 (53.3%) not screened, 42.2% of eligible babies died and 11.2% were
discharged and did not return for screening. Rates of any ROP, Type 1 ROP and
more advanced ROP (stages 4 and 5) were 32.2%, 9.7% and 0.7%, respectively. Among
the 170 infants with Type 1 and more advanced ROP (i.e. severe ROP) 45% had a GA
of 30-35 weeks, 18.8% had a GA of ??32 weeks, and 25% had a BW of >?1500 g. The
average inpatient stay was 10.7 days, and nearly all infants required outpatient
screening. The total number of examinations was 4,007 with an average of 2.4 per
patient. DISCUSSION: The third epidemic of ROP has arrived in Pakistan. There is
an urgent need to scale up screening and treatment. Effective screening programs
in public hospitals can be established with current resources. Initial screening
guidelines need to include at least a GA of ??35 weeks. Most infants will require
outpatient screening after discharge. Estimates of screening and treatment burden
can be made from these data for similar institutions initiating ROP screening
programs. CONCLUSIONS: Effective screening is achievable in public hospitals
using existing resources, especially with committed staff. The 35 weeks GA
protocol is essential, and outpatient care must be integrated into program
planning. Limitations include single-site data and lack of retinal imaging, but
all examinations were conducted by experienced ophthalmologists.
|*Hospitals, Public/statistics & numerical data
[MESH]
|*Neonatal Screening/methods
[MESH]
|*Retinopathy of Prematurity/epidemiology/diagnosis
[MESH]
|*Tertiary Care Centers/statistics & numerical data
[MESH]