Screen the World

Retinopathy of prematurity (ROP) is a significant cause of childhood blindness — in 2010, 20,000 children became blind or severely visually impaired due to ROP, and that number is set to increase (1). Interventions such as laser therapy, cryotherapy and anti-VEGF drugs can improve visual outcomes, and screening helps save sight: premature babies should be screened within a few weeks of birth to monitor for the presence – and severity – of retinopathy. But how many countries actually have ROP screening programs and guidelines? And how were these developed? To find out more, an international research team asked ophthalmologists in 141 countries to complete an online survey about ROP services in their nation (2). Here are the findings:

• Of the 141 countries contacted, 92 (65 percent) completed the survey. The lowest response rate was from African countries.
• A total of 78 countries (85 percent) reported having ROP screening in some centers.
• Of the 14 countries that reported having no ROP screening, one was European, two were Asian, and 11 were African.
• Of the countries that completed the survey, 68 (88 percent) reported having defined screening guidelines; 31 of these were developed through collaborations between pediatric and ophthalmology societies, with the remainder being produced by ophthalmologists alone (15 countries) and local hospitals (18 countries) – four were unspecified.
• Seven countries reported only having one or two screening centers: Azerbaijan, Bosnia and Herzegovina, Lithuania, Montenegro, Myanmar, Bahrain and Qatar.
• Three countries only have one or two ophthalmologist screeners:  Montenegro (one screener for a population of 626,000, and 3,400 births per year), Macedonia (one for a population of 2,080,000, and 10,600 births per year) and Bosnia and Herzegovina (two for a population of 3,870,000, and 15,800 births per year).

The authors conclude that their findings will allow “Ministries of Health and other agencies and organizations involved in the prevention of blindness in children to direct their efforts to those areas most in need as services for preterm infants expand in low-income countries.”