Adopting Western Retinopathy of Prematurity Screening Programs in Eastern Countries, are we Screening Properly?

PURPOSE: To describe retinopathy of prematurity (ROP) among Jordanian preterm infants and evaluate the efficacy of applying current Western screening guidelines for Jordanian preterms. MATERIALS AND METHODS: In this retrospective, descriptive hospital-based study, we collected data on preterm infants who were referred by their neonatologist for ROP screening at King Abdullah University Hospital between July 2006 and June 2007. Guidelines suggested by the American Academy of Pediatrics were followed. Additionally, older preterms considered at risk for ROP by the neonatal intensive care unit were screened. Any neonate with stage 1 ROP or higher in either eye was considered a positive case of ROP. RESULTS: Ninety-one preterms were included in the study. The median birth weight was 1390 gm (range,730-1980 gms) and the gestational age ranged from 26 to 35 weeks with 64.8% of preterms ≤ 32 weeks. ROP occurred in 28.6% of all patients, in 20% of infants with birth weight greater than 1500 gms and in 9.4% of preterms with gestational age ≥ 32 weeks. Six patients (6.6%) required laser treatment, two with low birth weight greater than 1250 gm and one was 33 weeks of age. Consanguinity was identified in 19.2% of infants with ROP while consanguinity in infants who did not develop ROP was 1.9%. This difference was statistically significant (P<0.05). CONCLUSION: ROP occurs in premature infants in Jordan with gestational age above 32 weeks and birth weight above 1250 gm. Future guidelines for screening should incorporate the current study outcomes. A prospective, population-based is required to set national guidelines for ROP screening in the Jordanian population and similarly for different populations worldwide. Consanguinity may play a role in ROP development and further genetic studies may aid in elucidating the pathogenesis of ROP.