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Comparison of the detection rates for retinopathy of prematurity (ROP) of the 2013 Philippine Academy of Ophthalmology (PAO) Revised Philippine Guidelines and the 2005 PAO-Philippine Pediatric Society (PPS) Guidelines for ROP screening in the Philippine General Hospital: a 5-year review
  1. Jose Antonio Tan Paulino1,
  2. Alvina Pauline Dy Santiago1,2,3,
  3. Darby Espiritu Santiago1,3
  1. 1Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila, Metro Manila, Philippines
  2. 2Philippine Eye Research Institute, Manila, Philippines
  3. 3UP College of Medicine - University of the Philippines - Manila, Manila, Philippines
  1. Correspondence to Dr Jose Antonio Tan Paulino; toniccipaulino{at}gmail.com

Abstract

Objectives Compare the detection rates of the 2013 Philippine Academy of Ophthalmology (PAO) guidelines for retinopathy of prematurity (ROP) screening and the 2005 PAO-Philippine Pediatric Society guidelines in identifying infants who develop ROP in the 5-year study period in the Philippine General Hospital (PGH). Secondary objectives include determination of ROP prevalence; correlation of gestational age (GA), birth weight (BW) and other risk factors to ROP; and identification of the most common intervention.

Methods and analysis Retrospective cross-sectional study of ROP records between 1 December 2013 and 30 November 2018 from the Medical Retina Service of the Department of Ophthalmology and Visual Sciences of the institution was studied. Variables with p value <0.05 were considered significant. STATA V.14 was used for all analysis.

Results Only 851 of 898 infants screened for ROP were included in the study. Of these 698 would have been screened based on 2005 guidelines. All 118 infants with ROP were identified by both guidelines. Detection rate was higher using the 2005 than the 2013 guidelines (16.9% vs 13.3%, p value=0.0496). ROP prevalence was 9.7%. Among those with ROP, 70% have at least one identified risk factor, topped by sepsis, pneumonia, hyaline membrane disease, blood transfusion and oxygen supplementation. Only 8% required intervention consisting of laser, anti-vascular endothelial growth factor injection, surgery or in combination.

Conclusion In PGH, no infants with ROP were missed using the 2005 recommendations. There was no added benefit of increasing threshold for BW and GA as recommended by the 2013 PAO guidelines. Screening guidelines should, however, be tailored to institutional needs, requirements and experience.

  • child health (paediatrics)
  • epidemiology
  • neovascularisation
  • retina
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Footnotes

  • Contributors All authors planned the study. JATP collected and analysed the data and submitted the study. All authors wrote the discussion.

  • Funding This research received a partial publication grant after completion of the study from the University of the Philippines Medical Alumni Society in America (UPMASA). No other specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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