Background: Retinopathy of the prematurity (ROP) is a serious disease which occurs in premature newborns. ROP is one of the main causes of preventable blindness in children and can affect up to 34% of premature children.
Objectives:To present the collaborative process of developing and evidence-based clinical practice guideline (CPG) for management of ROP for Latin-American.
Methods: A CPG was developed using the WHO developing manual with the support of Cochrane STI and the Iberoamerican Branch of GIN. The multidisciplinary GDG selected two CPGs for the adaptation process. The search was updated and new evidence synthesis and GRADE evidence profiles were created. The strength of the recommendations were graded during the II Symposium of The Prematurity Day with specialists of Latin-America.
Results:The CPG was elaborated with the following objectives: 1) To identify risk factors for occurrence of ROP in neonatal units; and, 2) to present the management strategies for screening, treatment and follow-up of newborns with ROP. Thirty recommendations were formulated which apply to all healthcare professionals who work in neonatal units. The GDG found challenging to formulate recommendations regarding ROP screening in premature newborns given the variability of health systems of Latin-America, the low access to a retinologist or pediatric ophthalmologist and the opportunity to referral to specialist on the recommended times. In areas, where access is low to specialists, telemedicine can be an alternative for ROP screening. Overall, the evidence of the guideline is low quality and the recommendations were formulated in order to maximise implementation and improve outcomes of children with ROP.
Conclusions:The development of a regional guideline faces several challenges. However, the collaborative efforts of networks, organisations and countries allows the production of a high-quality guideline with a high feasibility of implementation in different settings.