Retinopathy of prematurity screening and treatment practice patterns: an African multi-country survey.

purposeThis study aimed to assess current retinopathy of prematurity (ROP) screening and treatment practices among healthcare professionals across Africa.

methodsAn online in-depth survey consisting primarily of multiple-choice questions was sent to ophthalmologists and healthcare professionals involved in ROP care across Africa via professional networks, social media and word-of-mouth recommendations.

resultsA total of 62 respondents from 16 countries were included. ROP was considered a current or emerging public health problem by 95.2% of respondents. Although 91.9% of respondents reported having a neonatal intensive care unit in their facility or nearby, 51.6% indicated the absence of a formal referral pathway between neonatal and ophthalmology services. Anti-VEGF and laser photocoagulation were available for 90.3% and 56.5% of respondents, respectively. ROP screening criteria and treatment approaches were heterogeneous, with anti-VEGF therapy frequently being used as a first-line across all disease stages. Vitreoretinal services were located more than 200 km away or outside the country for 31.6% of respondents. The most frequently reported barriers to care were cost, lack of trained personnel, and limited integration between neonatal and ophthalmic services. Notably, 95.2% expressed interest in further training or participation in a regional ROP network.

conclusionROP practice patterns across Africa remain heterogeneous and are constrained, in many settings, by limited access to laser photocoagulation, inadequate integration with neonatal services, and gaps in formal training. The widespread use of anti-VEGF as first-line therapy across all stages of disease raises concern in settings where loss to follow-up is common.