Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register
Background/Aims To determine whether retinopathy of prematurity (ROP) screening is initiated on time according to current South African (SA) guidelines, that is, before the onset of stage 3 and type 1 ROP.Methods A prospective study of preterm infants screened at five neonatal units between 1 May 20...
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BMJ Publishing Group
2025-07-01
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| Series: | BMJ Open Ophthalmology |
| Online Access: | https://bmjophth.bmj.com/content/10/1/e002239.full |
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| author | Esme Jordaan Rudzani Muloiwa Adrie Bekker Gerd Holmström Clare Gilbert Michael Harrison Nicola Freeman Lloyd Tooke Phumza Nongena Natasha Rhoda Tshilidzi van der Lecq Teboho Seobi Linda Visser Tshilidzi van der Lecq Shakti Pillay Nicole Meiring Jaco Murray Adriaan Daniels Helga Abrahamse-Pillay Gugulabatembunamahlubi Kali Miemie Du Preez Alexander Geragotellis Neeran Reddy |
| author_facet | Esme Jordaan Rudzani Muloiwa Adrie Bekker Gerd Holmström Clare Gilbert Michael Harrison Nicola Freeman Lloyd Tooke Phumza Nongena Natasha Rhoda Tshilidzi van der Lecq Teboho Seobi Linda Visser Tshilidzi van der Lecq Shakti Pillay Nicole Meiring Jaco Murray Adriaan Daniels Helga Abrahamse-Pillay Gugulabatembunamahlubi Kali Miemie Du Preez Alexander Geragotellis Neeran Reddy |
| collection | DOAJ |
| description | Background/Aims To determine whether retinopathy of prematurity (ROP) screening is initiated on time according to current South African (SA) guidelines, that is, before the onset of stage 3 and type 1 ROP.Methods A prospective study of preterm infants screened at five neonatal units between 1 May 2022 and 31 January 2023 in Cape Town, SA. Data on all infants screened with a birth weight <1250 g or gestational age (GA) <32 weeks were extracted from the ROP South African (ROPSA) register, including postnatal age (PNA) and postmenstrual age (PMA) at first screening.Results A total of 696 infants were included, 58.9% (n=410) of whom had an early ultrasound (EUS) for GA estimation. Overall, 220 (31.6%) infants developed ROP, 20 (2.9%) had stage 3 or type 1 and 7 (1.0%) required treatment. Screening was initiated on time according to SA criteria in 549 (78.9%) infants, none of whom had stage 3 or type 1 ROP at first screening. Stage 3 and type 1 ROP were first detected at PNA and PMA of 6.3 and 33.1 and 8.9 and 35.9 weeks, respectively. Most infants (319, 45.8%) were screened according to PNA only, and 78.9% of the 185 infants screened only once did not attend subsequent examinations.Conclusion Screening started on time in most infants and prior to the development of severe ROP. Due to the limited availability of EUS in our region and to promote complete screening, we recommend that screening be initiated using PNA alone at 4–6 weeks or prior to discharge, whichever is earliest. The low proportion of infants with stage 3 and type 1 ROP is a limitation in our study. Therefore, recommendations may not be generalisable to South African regions where neonatal care results in a higher proportion of infants developing type 1 ROP. |
| format | Article |
| id | doaj-art-de3e3a000f704285affca31166fcc1aa |
| institution | DOAJ |
| issn | 2397-3269 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open Ophthalmology |
| spelling | doaj-art-de3e3a000f704285affca31166fcc1aa2025-08-20T03:12:30ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692025-07-0110110.1136/bmjophth-2025-002239Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register Esme Jordaan0Rudzani Muloiwa1Adrie BekkerGerd Holmström2Clare Gilbert3Michael HarrisonNicola Freeman4Lloyd Tooke5Phumza NongenaNatasha Rhoda6Tshilidzi van der Lecq7Teboho SeobiLinda VisserTshilidzi van der LecqShakti PillayNicole MeiringJaco MurrayAdriaan DanielsHelga Abrahamse-PillayGugulabatembunamahlubi KaliMiemie Du PreezAlexander GeragotellisNeeran ReddyBiostatistics Research Unit, South African Medical Research Council, Cape Town, South AfricaDepartment of Paediatrics & Child Health, University of Cape Town, Cape Town, South AfricaDepartment of Surgical Sciences, Ophthalmology, Uppsala University, Uppsala, SwedenClinical Research, London School of Hygiene and Tropical Medicine, London, UKDepartment of Surgery, Division of Ophthalmology, University of Cape Town, Cape Town, South AfricaDepartment of Paediatrics & Child Health, University of Cape Town, Cape Town, South AfricaDepartment of Paediatrics & Child Health, University of Cape Town, Cape Town, South AfricaDepartment of Surgery, Division of Ophthalmology, University of Cape Town, Cape Town, South AfricaBackground/Aims To determine whether retinopathy of prematurity (ROP) screening is initiated on time according to current South African (SA) guidelines, that is, before the onset of stage 3 and type 1 ROP.Methods A prospective study of preterm infants screened at five neonatal units between 1 May 2022 and 31 January 2023 in Cape Town, SA. Data on all infants screened with a birth weight <1250 g or gestational age (GA) <32 weeks were extracted from the ROP South African (ROPSA) register, including postnatal age (PNA) and postmenstrual age (PMA) at first screening.Results A total of 696 infants were included, 58.9% (n=410) of whom had an early ultrasound (EUS) for GA estimation. Overall, 220 (31.6%) infants developed ROP, 20 (2.9%) had stage 3 or type 1 and 7 (1.0%) required treatment. Screening was initiated on time according to SA criteria in 549 (78.9%) infants, none of whom had stage 3 or type 1 ROP at first screening. Stage 3 and type 1 ROP were first detected at PNA and PMA of 6.3 and 33.1 and 8.9 and 35.9 weeks, respectively. Most infants (319, 45.8%) were screened according to PNA only, and 78.9% of the 185 infants screened only once did not attend subsequent examinations.Conclusion Screening started on time in most infants and prior to the development of severe ROP. Due to the limited availability of EUS in our region and to promote complete screening, we recommend that screening be initiated using PNA alone at 4–6 weeks or prior to discharge, whichever is earliest. The low proportion of infants with stage 3 and type 1 ROP is a limitation in our study. Therefore, recommendations may not be generalisable to South African regions where neonatal care results in a higher proportion of infants developing type 1 ROP.https://bmjophth.bmj.com/content/10/1/e002239.full |
| spellingShingle | Esme Jordaan Rudzani Muloiwa Adrie Bekker Gerd Holmström Clare Gilbert Michael Harrison Nicola Freeman Lloyd Tooke Phumza Nongena Natasha Rhoda Tshilidzi van der Lecq Teboho Seobi Linda Visser Tshilidzi van der Lecq Shakti Pillay Nicole Meiring Jaco Murray Adriaan Daniels Helga Abrahamse-Pillay Gugulabatembunamahlubi Kali Miemie Du Preez Alexander Geragotellis Neeran Reddy Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register BMJ Open Ophthalmology |
| title | Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register |
| title_full | Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register |
| title_fullStr | Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register |
| title_full_unstemmed | Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register |
| title_short | Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register |
| title_sort | screening for retinopathy of prematurity in south africa are those developing severe rop screened on time data from a prospective register |
| url | https://bmjophth.bmj.com/content/10/1/e002239.full |
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