Retinopathy of Prematurity as a Multidisciplinary Approach: a Pediatrician’s Standpoint and Practice

Retinopathy of Prematurity as a Multidisciplinary Approach: a Pediatrician’s Standpoint and Practice

Retinopathy of prematurity (ROP) is a disease that affects blood vessel development in the retina of preterm infants with low birth weight. ROP is considered the second leading cause of blindness in children in the United States, however is also considered a preventable cause of blindness. ROP primarily affects preterm infants born at or before 32 weeks gestation with 1500 g or less birth weight. In Saudi Arabia, between 33-38.6% of preterm infants are diagnosed with ROP.

Screening preterm infants in the neonatal intensive care unit (NICU) after birth is crucial for ROP prognosis. Therefore, screening guidelines have been implemented to ensure a better outcome for those infants. In the United States, the American Academy of Pediatrics, the American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Ophthalmology recommends that all infants with a birth weight of 1500 g or less, or a gestational age of 30 weeks or less should be screened for ROP. In Saudi Arabia, the screening guidelines for ROP are a birth weight of 1500g or less, and/or gestational age of 32 weeks or less, preterm infants (≤36 weeks) receiving supplemental oxygen for 50 days or more, or those who receive frequent blood or exchange transfusions.

Technology advancements in the NICU setting, combined with higher standards of prenatal care, has resulted in a better survival rate among premature infants. However, the rate of ROP detection among premature infants has also increased within the last decade. Since pediatricians working in the NICU are the first physicians to examine preterm infants, assessing their knowledge regarding ROP is crucial.

This study aimed to measure the knowledge levels toward ROP among 41 NICU pediatricians in the major hospitals in Tabuk, Saudi Arabia, and is believed to be the first to assess awareness levels of ROP in the NICU. A self- administered online validated knowledge, attitude and practice (KAP) questionnaire was formulated and distributed with a scoring system in data analysis dependant on the correct chosen answer, designed to capture the ROP knowledge level of participants. Most pediatricians recognized the important treatment modalities available for ROP (92.7%); however, only 24.4% of them could recognize that 32 weeks or less is the gestational age of the screening criteria for ROP. The overall knowledge score ranged between 4 and 10, out of a possible maximum of 12 with a mean ± SD of (6.68±1.47). The majority (75.6%) believe that the ROP treatment can successfully prevent blindness.

The above study results demonstrated that NICU pediatricians have a good knowledge base regarding the treatment modalities of ROP. However, their knowledge about the inclusion criteria of ROP screening was insufficient. Thus, the study’s authors have highlighted the necessity of raising the awareness level and the strict application of the clinical guidelines among NICU pediatricians and healthcare workers involved in managing ROP. To aid in supporting awareness, it is recommended to hold periodic educational seminars and workshops to disseminate essential information with ROP stakeholders and NICU healthcare workers

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^{Albalawi HB, Hashem F, Alharbi ANJ, et al. Retinopathy of Prematurity as Multidisciplinary Approach, a Pediatricians Standpoint, and Practice. J Multidiscip Healthc. 2022;15:153-159.}

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Retinopathy of Prematurity as Multidisciplinary Approach, a Pediatricians Standpoint, and Practice