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American Academy of Pediatrics

This policy is a revision of the policy in

  • 117(2):572
  • 108(3):809
From the American Academy of PediatricsPolicy Statement

Screening Examination of Premature Infants for Retinopathy of Prematurity

Walter M. Fierson, AMERICAN ACADEMY OF PEDIATRICS Section on Ophthalmology, AMERICAN ACADEMY OF OPHTHALMOLOGY, AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS and AMERICAN ASSOCIATION OF CERTIFIED ORTHOPTISTS
Pediatrics December 2018, 142 (6) e20183061; DOI: https://doi.org/10.1542/peds.2018-3061
Walter M. Fierson
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    FIGURE 1

    Scheme of retina of the right and left eyes showing zone borders and clock hours used to describe the location and extent of ROP. Diagrammatic representation of the potential total area of the premature retina, with zone I (the most posterior) symmetrically surrounding the optic nerve head (the earliest to develop) is shown. A larger retinal area is present temporally (laterally) rather than nasally (medially) (zone III). Only zones I and II are present nasally. The retinal changes discussed in recommendation 4 are usually recorded on a diagram such as this one.

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    TABLE 1

    Timing of First Eye Examination Based on Gestational Age at Birth

    Gestational Age at Birth, wkAge at Initial Examination, wk
    PostmenstrualChronologic
    22a319
    23a318
    24317
    25316
    26315
    27314
    28324
    29334
    30344
    Older gestational age, high-risk factorsb—4
    • Shown is a schedule for detecting prethreshold ROP with 99% confidence, usually before any required treatment. —, not applicable.

    • ↵a This guideline should be considered tentative rather than evidence based for infants with a gestational age of 22 to 23 wk because of the small number of survivors in these postmenstrual age categories.

    • ↵b Consider timing on the basis of the severity of comorbidities.

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Pediatrics
Vol. 142, Issue 6
1 Dec 2018
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Screening Examination of Premature Infants for Retinopathy of Prematurity
Walter M. Fierson, AMERICAN ACADEMY OF PEDIATRICS Section on Ophthalmology, AMERICAN ACADEMY OF OPHTHALMOLOGY, AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS, AMERICAN ASSOCIATION OF CERTIFIED ORTHOPTISTS
Pediatrics Dec 2018, 142 (6) e20183061; DOI: 10.1542/peds.2018-3061

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Screening Examination of Premature Infants for Retinopathy of Prematurity
Walter M. Fierson, AMERICAN ACADEMY OF PEDIATRICS Section on Ophthalmology, AMERICAN ACADEMY OF OPHTHALMOLOGY, AMERICAN ASSOCIATION FOR PEDIATRIC OPHTHALMOLOGY AND STRABISMUS, AMERICAN ASSOCIATION OF CERTIFIED ORTHOPTISTS
Pediatrics Dec 2018, 142 (6) e20183061; DOI: 10.1542/peds.2018-3061
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    • Subcommittee on Retinopathy of Prematurity, 2015–2018
    • Section on Ophthalmology Executive Committee, 2017–2018
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Related Articles

  • Fierson WM; American Academy of Pediatrics Section on Ophthalmology; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus; American Association of Certified Orthoptists. Screening Examination of Premature Infants for Retinopathy of Prematurity. Pediatrics. 2018;142(6):e20183061
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Cited By...

  • Incidence of retinopathy of prematurity in Germany: evaluation of current screening criteria
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  • New modifications of Swedish ROP guidelines based on 10-year data from the SWEDROP register
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