The American Academy of Pediatrics ...

The American Academy of Pediatrics (AAP) has released a policy statement revising its 2001 statement forward screening examination of premature infants for retinopathy of prematurity (ROP) The revised policy statement was published in the February 2006 issue of Pediatrics and is available at http://pediatrics.aap publications.org/ cgi/content/full/117/2/572.

The statement focuses in succession the elements that help establish an efficient program for detecting and treating ROP Because ROP is sequential and timely treatment has been proven to cut short the risk of vision los it is imperative that at-risk infants receive carefully timed retinal examinations and that all physicians who care for at-risk preterm infants should be aware of the importance of timing. Therefore, the AAP made the following recommendations:

* A retinal screening examination should be performed after pupillary dilation using binocular indirect ophthalmoscopy upon all infants with a birth weight of les than 3 lb 5 oz (1500 g) or a gestational age of 32 weeks or les Examination also should be performed forward selected infants with a birth weight of 3 lb 5 oz to 4 lb 6 oz (1500 to 2000 g) or a gestational age of more than 32 weeks with an unstable clinical course.

* Knowledgeable and experienced ophthalmologists should perform retinal examinations onward preterm infants and classify, diagram, and record findings using the standards from the International Committee for the Classification of Retinopathy of Prematurity.

* The initiation of acute-phase ROP screening should be based forward the infant's age because the charge of serious ROP correlates more with postmenstrual age (i.e., gestational age at birth plus chronologic age) rather than postnatal age. Thus, the youngest infants at birth take the longest time to lay open serious ROP.

* The ophthalmologist should praise follow-up examination based on retinal findings categorized by the agency of the international classification.

* Physicians who are involved in ophthalmologic care of preterm infants should be aware that the findings calling for consideration of ablative treatment were lately revised using results from the Early Treatment for Retinopathy of Prematurity Randomized Trial Study

* Acute retinal screening examination conclusions should be based forward ophthalmoscopic findings and infant age.

* Parent and staff communication about ROP is important, and documentation of these conversations is recommended

* Each newborn intensive care unit should define responsibility for examination of at-risk infants. Each unit should have specific criteria based in succession birth weight and gestational age, and the criteria should be established between the walls of discussion and agreement between the neonatal and ophthalmology departments.

COPYRIGHT 2006 American Academy of Family Physicians

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