This guide was developed to share our institutional practice patterns and practical recommendations for the screening and treatment of retinopathy of prematurity (ROP). Despite advances in neonatal care, substantial variability remains in ROP management and limited transfer of best practices, with ongoing cases of advanced retinal detachment reported even in high-income countries. While this guide may not be directly generalized to low- and middle-resourced settings, it may serve as a future blueprint as oxygen strategies and ROP management protocols continue to evolve.
Through the integration of standardized neonatal and ophthalmic protocols, we have observed no cases of stage 4 or stage 5 ROP, including transferred patients, since implementation in 2020 and have not performed any primary laser treatment. Our overarching treatment philosophy emphasizes strict oxygen management, early intervention with anti-VEGF therapy, followed by prophylactic laser treatment of persistent avascular retina at a postmenstrual age of 55–60 weeks.
Authors: Nimesh A. Patel, MD; Celine Chaaya, MD, MSc; Arthur Brant, MD; Megan Aurora, MD; Kathryn Delack, MSN, AORN, NNP-BC; Demitrios Vavvas, MD, PhD; Samuel J., McAleese, MD; Rodica Turcu, MD
