Abstract：
OBJECTIVE: To compile real-time data on the preferred mydriasis practice patterns for retinopathy of prematurity (ROP) screening in Europe.
METHODS: A cross-sectional online survey was conducted from December 2022 to January 2023, using a self-report online questionnaire which was distributed via email to the members of the European Pediatric Ophthalmological Society and the Greek National ROP Task Force. A six-week period of recruitment was determined, and a reminder email was sent after two weeks. Descriptive statistics were used to explore the data, which was summarized with frequencies and percentages.
RESULTS: Sixty-six responses were recorded (response rate: 29.5%), representing practices in 55 Neonatal Intensive Care Units from 21 European countries. In 94.5%, the applied mydriatic regimen consists of phenylephrine with at least one muscarinic antagonist, either tropicamide or cyclopentolate. The concentration of phenylephrine ranges from 0.5% to 5%, of tropicamide from 0.25% to 1%, and of cyclopentolate from 0.2% to 1%. The most commonly used regimen (43.6%) contains phenylephrine 2.5% and tropicamide 0.5%, administered either combined or separately. About 54.5% of the reported mydriatic solutions are non-commercial, in-house preparations. Systemic adverse events, including oxygen desaturation, bradycardia and cardiopulmonary arrest were reported in 14.5%.
CONCLUSIONS: There is considerable heterogeneity in the applied mydriatic regimens for ROP screening in Europe, reflecting the absence of universal guidelines. The wide use of in-house preparations underlines the gap in the pharmaceutical industry. Concern should be raised against the wide use of undiluted commercial drugs, that reach adult dose, in the fragile population of preterm infants.
METHODS: A cross-sectional online survey was conducted from December 2022 to January 2023, using a self-report online questionnaire which was distributed via email to the members of the European Pediatric Ophthalmological Society and the Greek National ROP Task Force. A six-week period of recruitment was determined, and a reminder email was sent after two weeks. Descriptive statistics were used to explore the data, which was summarized with frequencies and percentages.
RESULTS: Sixty-six responses were recorded (response rate: 29.5%), representing practices in 55 Neonatal Intensive Care Units from 21 European countries. In 94.5%, the applied mydriatic regimen consists of phenylephrine with at least one muscarinic antagonist, either tropicamide or cyclopentolate. The concentration of phenylephrine ranges from 0.5% to 5%, of tropicamide from 0.25% to 1%, and of cyclopentolate from 0.2% to 1%. The most commonly used regimen (43.6%) contains phenylephrine 2.5% and tropicamide 0.5%, administered either combined or separately. About 54.5% of the reported mydriatic solutions are non-commercial, in-house preparations. Systemic adverse events, including oxygen desaturation, bradycardia and cardiopulmonary arrest were reported in 14.5%.
CONCLUSIONS: There is considerable heterogeneity in the applied mydriatic regimens for ROP screening in Europe, reflecting the absence of universal guidelines. The wide use of in-house preparations underlines the gap in the pharmaceutical industry. Concern should be raised against the wide use of undiluted commercial drugs, that reach adult dose, in the fragile population of preterm infants.
摘要：
目的：收集欧洲早产儿视网膜病变（ROP）筛查首选散瞳实践模式的实时数据。
方法：于2022年12月至2023年1月进行了一项横断面在线调查，使用自我报告在线问卷，该问卷通过电子邮件分发给欧洲儿科眼科学会和希腊国家ROP工作组的成员。确定了为期六周的招聘时间,两周后发送了一封提醒电子邮件。描述性统计被用来探索数据，用频率和百分比进行了总结。
结果：记录了66个响应（响应率：29.5％），代表来自21个欧洲国家的55个新生儿重症监护病房的实践。94.5%，应用的散瞳方案由苯肾上腺素和至少一种毒蕈碱拮抗剂组成，托吡卡胺或环戊酸酯。去氧肾上腺素的浓度范围从0.5%到5%,从0.25%到1%的托吡卡胺，和0.2％至1％的环戊酸酯。最常用的方案（43.6％）包括去氧肾上腺素2.5％和托吡卡胺0.5％，联合或单独给药。报道的散瞳溶液中约有54.5％是非商业的，内部准备工作。系统性不良事件，包括氧饱和度,14.5%的患者报告了心动过缓和心肺骤停.
结论：在欧洲，用于ROP筛查的散瞳疗法存在相当大的异质性，反映缺乏普遍准则。内部制剂的广泛使用突显了制药行业的差距。应引起人们对广泛使用未经稀释的商业药物的关注，达到成人剂量，在脆弱的早产儿人群中。
方法：于2022年12月至2023年1月进行了一项横断面在线调查，使用自我报告在线问卷，该问卷通过电子邮件分发给欧洲儿科眼科学会和希腊国家ROP工作组的成员。确定了为期六周的招聘时间,两周后发送了一封提醒电子邮件。描述性统计被用来探索数据，用频率和百分比进行了总结。
结果：记录了66个响应（响应率：29.5％），代表来自21个欧洲国家的55个新生儿重症监护病房的实践。94.5%，应用的散瞳方案由苯肾上腺素和至少一种毒蕈碱拮抗剂组成，托吡卡胺或环戊酸酯。去氧肾上腺素的浓度范围从0.5%到5%,从0.25%到1%的托吡卡胺，和0.2％至1％的环戊酸酯。最常用的方案（43.6％）包括去氧肾上腺素2.5％和托吡卡胺0.5％，联合或单独给药。报道的散瞳溶液中约有54.5％是非商业的，内部准备工作。系统性不良事件，包括氧饱和度,14.5%的患者报告了心动过缓和心肺骤停.
结论：在欧洲，用于ROP筛查的散瞳疗法存在相当大的异质性，反映缺乏普遍准则。内部制剂的广泛使用突显了制药行业的差距。应引起人们对广泛使用未经稀释的商业药物的关注，达到成人剂量，在脆弱的早产儿人群中。
