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Epidemiology
Nov 2012

Swedish National Register for Retinopathy of Prematurity (SWEDROP) and the Evaluation of Screening in Sweden

Author Affiliations
 

SECTION EDITOR: LESLIE HYMAN, PhD

Author Affiliations: Department of Neuroscience/Ophthalmology, University Hospital, Uppsala (Dr Holmström); Section of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Dr Hellström); Department of Ophthalmology, Linkoping University, Linkoping (Dr Jakobsson); Division of Ophthalmology, Department of Clinical Sciences, Umeå University, Umeå (Dr Lundgren); Department of Ophthalmology, Lund University Hospital, Lund (Dr Tornqvist); and St Erik's Eye Hospital, Stockholm (Dr Wallin), Sweden.

Arch Ophthalmol. 2012;130(11):1418-1424. doi:10.1001/archophthalmol.2012.2357
Abstract

Objectives To evaluate screening for retinopathy of prematurity (ROP) in Sweden and to investigate possible modifications of the present screening guidelines.

Methods Infants in Sweden with a gestational age (GA) of 31 weeks + 6 days or less are screened for ROP. Data from the Swedish national register for ROP (SWEDROP) during 2008 and 2009 were extracted and compared with a national perinatal quality register.

Results In SWEDROP, there were 1791 infants born before a GA of 32 weeks from January 1, 2008, through December 31, 2009. Another 70 infants were registered in the perinatal quality register but not in SWEDROP (dropout rate, 3.8% [70 of 1861 infants]). Seven infants died before termination of screening. In the final study cohort (1784 infants), 15.6% had mild ROP and 8.5% had severe ROP. Treatment was performed in 4.4% of the infants, none of whom had a GA at birth of more than 28 weeks. Nine infants with a GA of more than 28 weeks at birth developed stage 3 ROP, which regressed spontaneously. The total number of examinations was 9286 (964 in infants with a GA of 31 weeks), and the mean (range) number of examinations of each infant was 5.2 (1-30).

Conclusions The SWEDROP, a quality register for ROP, has a national coverage (ie, participation) of 96%. Data from 2008 to 2009 show that it seems possible to reduce the upper limit for screening in Sweden by 1 week, including only infants with a GA of 30 weeks + 6 days or less. However, such a change should be combined with a strong recommendation to neonatologists to refer also severely ill and more “mature” infants.

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