MCQs In Neonatal Ophthalmology

Q 1:

You are treating a former extremely low-gestational age newborn (ELGAN) who was born at 26

weeks’ gestation weighing 700 g. She is now 4 weeks old. Her nurse asks when the eye

examination for retinopathy of prematurity (ROP) will be performed and what risk for significant

visual impairment exists in this infant.

Of the following, the BEST time to obtain the first ROP screening eye examination in this infant is

A. 4 weeks after discharge from the hospital

B. 4 weeks after weaning from oxygen

C. 5 weeks after birth

D. 5 weeks after the expected delivery date

E. 5 weeks after weaning from the ventilator

Answer

C

The American Academy of Pediatrics recommends a specific timetable for testing at-risk
preterm infants . In general, infants should be tested between 31 and 34 weeks
gestational age. Accordingly, the infant described in the vignette should be tested 5 weeks after
birth.

Because most 26 weeks' gestation infants are discharged from the hospital at a gestational
equivalent of 34 to 36 weeks, or 8 to 10 postnatal weeks of age, this would be too late for an
initial examination, as would one occurring 4 weeks later. Many 26 weeks' gestation infants may
have chronic lung disease and be receiving assisted ventilation for days to weeks or be
discharged from the hospital on oxygen, so screening is not based on the time of weaning from
assisted ventilation or oxygen. Five weeks after the expected delivery date is too late for initial
screening.