A preterm neonate born at 29 weeks gestation is admitted to the NICU. According to standard retinopathy of prematurity (ROP) screening guidelines, when should the first fundus examination be performed?
- A At birth, before discharge from the delivery room
- B At 31 to 32 weeks postmenstrual age, or 4 weeks after birth, whichever is later ✓
- C At 40 weeks postmenstrual age, regardless of birth weight
- D Only if leukocoria is noticed by the nursing staff
Correct answer: B. At 31 to 32 weeks postmenstrual age, or 4 weeks after birth, whichever is later
Explanation
Screening begins at 31 to 32 weeks postmenstrual age or 4 weeks after birth, whichever comes later, because acute phase ROP rarely appears before this window and early examination wastes dilated exams without detecting treatable disease. Screening too late risks missing zone II stage 3 with plus disease, the sight-threatening threshold. Waiting until term equivalent age would miss the critical period, since type 1 ROP requires treatment within about 72 hours of diagnosis.
Reference: AAO Basic and Clinical Science Course, Section 12: Retina and Vitreous, Recent edition ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.