USE OF BIRTH WEIGHT IN SCREENING FOR RETINOPATHY OF PREMATURITY IN SRI LANKA. DO WE NEED A CHANGE IN CUT- OFF BIRTH WEIGHT?

Abstract

Background - Constant revision of screening guidelines for retinopathy of prematurity(ROP)
resulted in birth weight cut-off being lowered in some western centres. However, countries
with limited neonatal care reports that more mature, bigger babies being detected with
significant ROP.
Objectives - To find whether lowered cut-off birth weight criterion in screening for ROP are
safe to be applied in Sri Lanka and whether current cut-off limit needs revision.
Methods - A retrospective study was carried out on babies screened during a one year period
in a tertiary care ophthalmology centre. Gestational age less than 32 weeks and / or birth
weight less than 1500 grams were used as primary screening criteria. Some older and heavier
babies were also screened due to exposure to risk factors.
Results - ROP was diagnosed in 89 (31.6%) out of 282 babies studied. Severe ROP was
detected in 52 babies. Mean birth weight for those needing treatment was 1209 ± 282 grams.
six infants(6.5%) older than 32 weeks and heavier than 1250 grams(a lowered cut-off used in
some units) received treatment. Four of them(5%) were heavier than 1500 grams. Of the babies
born heavier than 1250 grams, those born before 32 weeks of gestation had a higher chance of
developing ROP.(p < 0.0006)
Conclusion - ROP still occurs in heavier and older babies in Sri Lanka. A reduction in birth
weight cut-off limit is not advisable. Current guidelines need revision as some babies heavier
than current cut-off had treatable ROP.