Diagnostic Accuracy of WINROP, CHOP-ROP and ROPScore in Detecting Type 1 Retinopathy of Prematurity

On magnetic resonance (MR) imaging, Modic type 1 (MT1) endplate changes and infectious spondylodiscitis share similar findings. Therefore, this study investigated vertebral bone marrow and endplate changes to enable their differentiation. The lumbar spine MR examinations of 91 adult patients were retrospectively included: 39 with MT1; 19 with early spondylodiscitis without abscess; and 33 with advanced spondylodiscitis with abscess. The assessment included percentage of bone marrow edema on sagittal short tau inversion recovery images, and the signal ratio of edema to unaffected bone and endplate contour (normal; irregular, yet intact; blurred; destructive) on sagittal unenhanced T1-weighted images. Differences were tested for statistical significance by Chi-square test and mixed model analysis of variance. The MR diagnostic accuracy in differentiating MT1 and spondylodiscitis was assessed by cross-tabulation and receiver-operating characteristic analysis. The endplate contours, edema extents, and T1-signal ratios of MT1 (extent, 31.96%; ratio, 0.83) were significantly different (p < 0.001) from early spondylodiscitis (56.42%; 0.60), and advanced spondylodiscitis (91.84%; 0.61). The highest diagnostic accuracy (sensitivity, 94.87%; specificity, 94.23%; accuracy, 94.51%) in identifying MT1 was provided by an irregular, yet intact endplate contour. This may be a useful MR feature for the differentiation between MT1 and spondylodiscitis, particularly in its early stage.

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Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316401 ◽

2020 ◽

pp. bjophthalmol-2020-316401

Author(s):

Qian Yang ◽

Xiaohong Zhou ◽

Yingqin Ni ◽

Haidong Shan ◽

Wenjing Shi ◽

...

Keyword(s):

Cohort Study ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Predictive Performance ◽

Screening Guideline ◽

Postmenstrual Age ◽

The Mean ◽

Type 1 Rop ◽

Rop Screening

PurposesTo develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).MethodsA multicentre retrospective cohort study was conducted based on data from four tertiary neonatal intensive care units in Shanghai, China. The medical records of enrolled infants, born from 2012 to 2016 who underwent ROP examinations, were collected and analysed. The incidence and risk factors for ROP were analysed in all infants. Postnatal age (PNA) and postmenstrual age (PMA) of infants, detected to diagnose ROP for the first time, were compared with the present examination schedule. The predictive performance of screening models was evaluated by internally validating sensitivity and specificity.ResultsOf the 5606 eligible infants, ROP was diagnosed in 892 (15.9%) infants; 63 (1.1%) of them received treatment. The mean GA of ROP patients was 29.4±2.4 weeks, and the mean BW was 1260±330 g. Greater prematurity was associated with an older PNA at which ROP developed. The minimum PMA and PNA at which diagnosis of treatable ROP occurred were 32.43 and 3 weeks, respectively. The optimised criteria (GA <32 weeks or BW <1600 g) correctly predicted 98.4% type 1 ROP infants, reducing the infants requiring examinations by 43.2% when internally validated.ConclusionsThe incidence of type 1 ROP and the mean GA and BW of ROP infants have decreased in China. The suggested screening threshold and schedule may be reliably used to guide the modification of ROP screening guideline and decrease medical costs.

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Efficacy of ultra-low-dose (0.1 mg) ranibizumab intravitreal injection for treatment of prethreshold type 1 retinopathy of prematurity: A case series

European Journal of Ophthalmology ◽

10.1177/1120672118812266 ◽

2018 ◽

Vol 30 (1) ◽

pp. 40-47 ◽

Cited By ~ 2

Author(s):

Islam SH Ahmed ◽

Ahmed MA Hadi ◽

Hassan H Hassan

Keyword(s):

Side Effects ◽

Intravitreal Injection ◽

Retinopathy Of Prematurity ◽

Large Scale ◽

Low Dose ◽

Case Series ◽

Results Of Treatment ◽

Case Series Study ◽

Systemic Side Effects

Aim: To report the results of treatment of type 1 prethreshold retinopathy of prematurity using intravitreal injection of ultra-low dose of ranibizumab (0.1 mg in 0.01 mL). Design: A retrospective observational case series study. Methods: Review of files of eligible infants who received this form of treatment to determine the outcome of treatment and any associated ocular or systemic side effects. Results: The study included 24 eyes of 12 preterm infants with mean gestational age of 29.75 ± 1.54 weeks and mean birth weight of 1074.58 ± 320.59 g. A total of 22 eyes (91.67%) had zone II disease while 2 eyes of one infant (8.33%) had zone I disease. All cases showed regression of the signs of the active retinopathy of prematurity with complete retinal vascularization. None of the cases required retreatment. Three eyes developed ocular complications. Apart from mild feeding intolerance that lasted for 24 h after injection in one infant, none of the cases developed systemic side effects. Conclusion: Intravitreal injection of ultra-low-dose ranibizumab showed promising efficacy and good ocular safety. However, further large-scale studies are required to give stronger evidence about the efficacy and safety of ultra-low-dose ranibizumab.

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Evaluation of a deep learning image assessment system for detecting severe retinopathy of prematurity

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313156 ◽

2018 ◽

Vol 103 (5) ◽

pp. 580-584 ◽

Cited By ~ 20

Author(s):

Travis K Redd ◽

John Peter Campbell ◽

James M Brown ◽

Sang Jin Kim ◽

Susan Ostmo ◽

...

Keyword(s):

Deep Learning ◽

Retinopathy Of Prematurity ◽

Predictive Value ◽

Severity Score ◽

Receiver Operating Curve ◽

Fundus Photography ◽

Image Analysis System ◽

Reference Standard ◽

Type 1 Rop

BackgroundPrior work has demonstrated the near-perfect accuracy of a deep learning retinal image analysis system for diagnosing plus disease in retinopathy of prematurity (ROP). Here we assess the screening potential of this scoring system by determining its ability to detect all components of ROP diagnosis.MethodsClinical examination and fundus photography were performed at seven participating centres. A deep learning system was trained to detect plus disease, generating a quantitative assessment of retinal vascular abnormality (the i-ROP plus score) on a 1–9 scale. Overall ROP disease category was established using a consensus reference standard diagnosis combining clinical and image-based diagnosis. Experts then ranked ordered a second data set of 100 posterior images according to overall ROP severity.Results4861 examinations from 870 infants were analysed. 155 examinations (3%) had a reference standard diagnosis of type 1 ROP. The i-ROP deep learning (DL) vascular severity score had an area under the receiver operating curve of 0.960 for detecting type 1 ROP. Establishing a threshold i-ROP DL score of 3 conferred 94% sensitivity, 79% specificity, 13% positive predictive value and 99.7% negative predictive value for type 1 ROP. There was strong correlation between expert rank ordering of overall ROP severity and the i-ROP DL vascular severity score (Spearman correlation coefficient=0.93; p<0.0001).ConclusionThe i-ROP DL system accurately identifies diagnostic categories and overall disease severity in an automated fashion, after being trained only on posterior pole vascular morphology. These data provide proof of concept that a deep learning screening platform could improve objectivity of ROP diagnosis and accessibility of screening.

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The Use of Postnatal Weight Gain Algorithms to Predict Severe or Type 1 Retinopathy of Prematurity

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.35879 ◽

2021 ◽

Vol 4 (11) ◽

pp. e2135879

Author(s):

Sam Athikarisamy ◽

Saumil Desai ◽

Sanjay Patole ◽

Shripada Rao ◽

Karen Simmer ◽

...

Keyword(s):

Weight Gain ◽

Retinopathy Of Prematurity ◽

Postnatal Weight Gain

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Incidence and Characteristics of Infants with Retinopathy of Prematurity in Croatia

Integrative Pediatrics and Child Care ◽

10.18314/ipcc.v1i1.1258 ◽

2018 ◽

Vol 1 (1) ◽

pp. 35-45

Author(s):

Mirjana Vucinovic ◽

Ljubo Znaor ◽

Ana Vucinovic ◽

Vesna Capkun ◽

Julijana Bandic

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Small For Gestational Age ◽

Neonatal Intensive Care ◽

Type 1 Rop

PURPOSE: To study the incidence of retinopathy of prematurity (ROP) in a neonatal intensive care unit in Croatia and obtain information on risk factors associated with ROP. There have been limited studies on ROP in Croatia where the screening for ROP and its treatment is still insufficient and not introduced in many intensive care units. MATERIAL AND METHODS: This retrospective study included 247 premature infants admitted to the neonatal intensive care unit of University Hospital Split, over a 5-year period between January 2012, and December 2016. In this paper the relationship between clinical risk factors and the development of ROP was analyzed. RESULTS: The overall incidence for ROP was 23,9 % (59 infants), for Type 1 ROP was 9,3% (23 infants); for Type 2 ROP was 14,6% (36 infants). Median gestational age (GA) and birthweight (BW) were significantly lower among infants with ROP versus those without ROP (29: 23-34 vs. 31: 23-34,p<0,001 and 1,180:630-2,000 vs. 1485:590-2000, p<0,001 respectively). Multivariate analysis showed that only BW (p=0,029) and small for gestational age (SGA) (p=0,045) predicted the development of ROP. CONCLUSION: Birth weight and small for gestational age were the most significant risk factors for developing ROP. In comparison with studies from highly developed countries, infants with a much wider range of gestational age and birth weights are developing Type 1 ROP.

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Differences in Risk Factors for Retinopathy of Prematurity Development in Paired Twins: A Chinese Population Study

The Scientific World JOURNAL ◽

10.1155/2014/212183 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Gordon S. K. Yau ◽

Jacky W. Y. Lee ◽

Victor T. Y. Tam ◽

Stan Yip ◽

Edith Cheng ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Retinopathy Of Prematurity ◽

Very Low Birth Weight ◽

Significant Risk ◽

The Mean ◽

Record Review ◽

Chinese Twins ◽

Retrospective Medical Record Review

Purpose.To determine the differences in risk factors for retinopathy of prematurity (ROP) in paired twins.Methods.A retrospective medical record review was performed for all paired twins screened for ROP between 2007 and 2012. Screening was offered to very low birth weight (≤1500 grams) and preterm (≤32 weeks) neonates. Twins 1 and 2 were categorized based on the order of delivery. Maternal and neonatal covariates were analyzed using univariate and multivariate regression analyses for both ROP and Type 1 ROP.Results.In 34 pairs of Chinese twins, the mean gestational age (GA) was 30.2 ± 2.0 weeks. In Twin 1, smaller GA (OR = 0.44,P=0.02), higher mean oxygen concentration (OR = 1.34,P=0.03), presence of thrombocytopenia (OR = 1429.60,P<0.0001), and intraventricular hemorrhage (OR = 18.67,P=0.03) were significant risk factors for ROP. For Twin 2, a smaller GA (OR = 0.45,P=0.03) was the only risk factor. There were no significant risk factors for ROP in Twin 1 or Twin 2 on multivariate analysis.Conclusion.In Chinese twin pairs, smaller GA was the only common risk factor for ROP while Twin 1 was more susceptible to the postnatal risks for ROP.

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