Guideline for the screening and treatment of retinopathy of prematurity

Retinopathy of prematurity (ROP) is one of the few causes of childhood visual disability which is largely preventable. Many extremely preterm babies will develop some degree of ROP although in the majority this never progresses beyond mild disease which resolves spontaneously without treatment. A small proportion, develop potentially severe ROP which can be detected through retinal screening. If untreated, severe disease can result in serious vision impairment and consequently all babies at risk of sight-threatening ROP should be screened. This evidence-based guideline for the screening and treatment of ROP was developed by a multidisciplinary guideline development group (GDG) of the Royal College of Paediatrics & Child Health (RCPCH) in collaboration with the Royal College of Ophthalmologists (RCOphth), British Association of Perinatal Medicine (BAPM) and the premature baby charity BLISS. The guideline was produced according to RCPCH standards for guideline development. 1 The guideline provides 25 evidence-based recommendations and 21 good practice points. Recommendations are graded A-D using SIGN grading hierarchy, 2 according to the strength of the evidence underpinning them. The good practice points (GPP) are a consensus of the GDG. This Executive Summary highlights those recommendations and good practice points considered by the GDG to be priorities for implementation. This guideline has been produced specifically for use within the UK and supersedes the previous guideline. 3 It will not be applicable in countries where more mature babies are at risk of sight threatening ROP. 4 Not all the recommendations are included in this Summary. The full Guideline should be consulted which also contains complete details of the Guideline methodology. Appendices A, B, C and D give a standardised sheet for recording screening results, an algorithm for ophthalmic criteria for screening and treatment, the International Classification of ROP Revisited, and parent information leaflets respectively. All the documents are available on the websites of the Royal College of Ophthalmologists www.rcophth.ac.uk, the Royal College of Paediatrics and Child Health www. rcpch.ac.uk/ROP or the British Association of Perinatal Medicine www.bapm.org. The guideline will be updated within five years of its publication date