We read with interest the article by Durnian and Clark who presented a retrospective cohort of infants that fell outside evidence level B guidelines for screening retinopathy of prematurity (ROP) and we wish to discuss some further points. The data presented in table 1 highlight that all 11 babies would be missed if screening was according to level B evidence and 2 of these would still be missed using the good practice points evidence. An alternative conclusion would be that if the guidelines had been amended to screen infants under 32 weeks or 1251 g then one extra baby would have been missed (who fortunately did not require treatment). It is also debatable based on the information presented, if any of the babies absolutely required treatment as others may have opted to observe the fibrovascular ridge seen in zone 3 in cases 3 and 12. The screening criteria should allow the test to be not only highly sensitive but also specific. In order to present a complete discussion, we would ideally like to know over the same time period how many examinations would have been avoided if the screening criteria were at the secondary level (B) and also importantly if the criteria were amended to less than 32 weeks or 1251g.
展开▼
