National variations in retinopathy of prematurity screening criteria in Canada: existent guidelines and actual practice patterns

OBJECTIVE: To survey the current inclusion criteria used for retinopathy of prematurity (ROP) screening across tertiary level 3 neonatal intensive care units (NICUs) in Canada. PARTICIPANTS: Clinical directors from 29 level 3 NICUs in Canada. METHODS: Survey of all 29 level 3 NICUs in Canada in September 2010. The survey inquired about the current ROP screening criteria in use in each centre including which neonates are enrolled in the screening program and the timing of when screening begins. The survey was sent via email to the clinical directors at each site. Nonrespondents were contacted by telephone. RESULTS: In total, 23 centres replied, representing a 79% response rate with the survey. Seven different ROP screening inclusion criteria were found to be in use, although one of the centres did not have a clear inclusion protocol. The variation between centres was significant, with some using a combination of birth weight and gestational age and others using birth weight or gestational age alone as their criterion. There was also variation in the timing of initial eye examinations, with 8 different criteria currently in use. Discrepancies were also found among treatment patterns at the centres. CONCLUSIONS: Despite the publication of updated Canadian guidelines in 2000, there continues to be significant variation in the actual inclusion criteria being used across the country. Therefore, a need exists for comprehensive, evidence-based Canadian guidelines to optimize the screening inclusion criteria for ROP.