Evaluation of the economic impact of modified screening criteria for retinopathy of prematurity from the Postnatal Growth and ROP (G-ROP) study

Purpose: Retinopathy of prematurity (ROP) is the leading cause of childhood blindness. The aim of our study is to validate the new screening criteria elaborated by the Postnatal Growth and Retinopathy of Prematurity (G-ROP) study group in a monocentric cohort of Italian preterm infants. Methods: We retrospectively applied the G-ROP screening criteria to a cohort of preterm infants born between May 2015 and July 2020 with known birth weight, gestational age, serial weight measurement, and known ROP outcome. Primary outcomes were sensitivity and specificity of ROP detection, especially of treatment requiring ROP. Secondary outcomes were reduction of ophthalmologic examinations and of infants requiring screening. Results: We retrospectively evaluated 595 children and 475 were included in our study. Of them, 119 developed any type ROP, 39 developed type 1 ROP, and 28 underwent treatment. G-ROP criteria predicted 39 of 39 cases of type 1 ROP (100% sensitivity and specificity). Sensitivity and specificity for detection of treated ROP were 100%. Considering any type ROP detection, sensitivity was 87.4% and specificity was 100%. Our analysis showed that screening could be avoided in 50% of patients, resulting in a 29% reduction of the number of examinations. Conclusions: Our study validates the new G-ROP screening protocol in a monocentric cohort of premature infants. We demonstrate that all Type 1 ROP and requiring treatment ROP could be found even with a reduction of eye examinations.

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Validation of the postnatal growth and retinopathy of prematurity screening criteria

Baylor University Medical Center Proceedings ◽

10.1080/08998280.2020.1793709 ◽

2020 ◽

Vol 33 (4) ◽

pp. 546-549

Author(s):

Sean Wadley ◽

Matthew Recko ◽

Shoji Samson

Keyword(s):

Retinopathy Of Prematurity ◽

Postnatal Growth ◽

Screening Criteria

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Retrospective validation of the postnatal Growth and Retinopathy of Prematurity (G-ROP) criteria in a Swiss cohort

BMC Ophthalmology ◽

10.1186/s12886-021-02227-4 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Nithursa Vinayahalingam ◽

Jane McDougall ◽

Olaf Ahrens ◽

Andreas Ebneter

Keyword(s):

Prediction Model ◽

Retinopathy Of Prematurity ◽

High Sensitivity ◽

Postnatal Growth ◽

Complete Data ◽

Screening Criteria ◽

Treatment Type ◽

Type 1 Rop ◽

Rop Screening

Abstract Background Currently used screening criteria for retinopathy of prematurity (ROP) show high sensitivity for predicting treatment-requiring ROP but low specificity; over 90% of examined infants do not develop ROP that requires treatment (type 1 ROP). A novel weight gain-based prediction model was developed by the G-ROP study group to increase the specificity of the screening criteria and keep the number of ophthalmic examinations as low as possible. This retrospective cohort study aimed to externally validate the G-ROP screening criteria in a Swiss cohort. Methods Data from 645 preterm infants in ROP screening at Inselspital Bern between January 2015 and December 2019 were retrospectively retrieved from the screening log and analysed. The G-ROP screening criteria, consisting of 6 trigger parameters, were applied in infants with complete data. To determine the performance of the G-ROP prediction model for treatment-requiring ROP, sensitivity and specificity were calculated. Results Complete data were available for 322 infants who were included in the analysis. None of the excluded infants had developed type 1 ROP. By applying the 6 criteria in the G-ROP model, 214 infants were flagged to undergo screening: among these, 14 developed type 1 ROP, 9 developed type 2 ROP, and 43 developed milder stages of ROP. The sensitivity for predicting treatment-requiring ROP was 100% (CI, 0.79–1.00), and the specificity was 41% (CI, 0.35 –0.47). Implementing the novel G-ROP screening criteria would reduce the number of infants entering ROP screening by approximately one third. Conclusions The overall prevalence of treatment-requiring ROP was low (2.15%). Previously published performance parameters for the G-ROP algorithm were reproducible in this Swiss cohort. Importantly, all treatment-requiring infants were correctly identified. By using these novel criteria, the burden of screening examinations could be significantly reduced.

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Adequacy of published screening criteria for retinopathy of prematurity

Clinical and Experimental Ophthalmology ◽

10.1111/ceo.12628 ◽

2016 ◽

Vol 44 (2) ◽

pp. 121-127

Author(s):

Deepa A Taranath ◽

Dickson D-S Oh ◽

Miriam C Keane ◽

Helen Fabel ◽

Peter Marshall

Keyword(s):

Retinopathy Of Prematurity ◽

Screening Criteria

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Design of the postnatal growth and retinopathy of prematurity (G-ROP) study

Journal of American Association for Pediatric Ophthalmology and Strabismus ◽

10.1016/j.jaapos.2016.07.034 ◽

2016 ◽

Vol 20 (4) ◽

pp. e9

Author(s):

Lauren Tomlinson ◽

Gil Binenbaum

Keyword(s):

Retinopathy Of Prematurity ◽

Postnatal Growth

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A worldwide survey of retinopathy of prematurity screening

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310709 ◽

2017 ◽

Vol 102 (1) ◽

pp. 9-13 ◽

Cited By ~ 16

Author(s):

Justin S Mora ◽

Christopher Waite ◽

Clare E Gilbert ◽

Brenda Breidenstein ◽

John J Sloper

Keyword(s):

Low Income ◽

Retinopathy Of Prematurity ◽

Online Survey ◽

Low Income Countries ◽

Screening Criteria ◽

Middle Income ◽

Premature Babies ◽

Inadequate Knowledge ◽

The World ◽

Rop Screening

BackgroundTo ascertain which countries in the world have retinopathy of prematurity (ROP) screening programmes and guidelines and how these were developed.MethodsAn email database was created and requests were sent to ophthalmologists in 141 nations to complete an online survey on ROP screening in their country.ResultsRepresentatives from 92/141 (65%) countries responded. 78/92 (85%) have existing ROP screening programmes, and 68/78 (88%) have defined screening criteria. Some countries have limited screening and those areas which have no screening or for which there is inadequate knowledge are mainly Southeast Asia, Africa and some former Soviet states.DiscussionWith the increasing survival of premature babies in lower-middle-income and low-income countries, it is important to ensure that adequate ROP screening and treatment is in place. This information will help organisations focus their resources on those areas most in need.

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Retinopathy of Prematurity in A Tertiary Care Hospital in Eastern Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.213 ◽

2008 ◽

Vol 47 (169) ◽

Author(s):

Srijana Adhikari ◽

B P Badhu ◽

N K Bhatta ◽

R S Rajbhandari ◽

B K Kalakheti

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Screening Criteria

World Health Organization’s Vision 2020 program has recognized Retinopathy of Prematurity(ROP) as an important cause of childhood blindness in industrialized and developing countries. Inthe last few years, it has been identifi ed in many under developed countries as well, as a result ofimproved neonatal intensive care. In Nepal, ROP screening is carried out in a few tertiary hospitalsbut there is no published data on this disease. The purpose of this study was to fi nd out the incidence,severity and risk factors of ROP among infants screened in a tertiary care hospital in the EasternRegion of Nepal.A prospective cohort study was carried out in neonates with gestational age of 34 weeks or less and,or birth weight of 1700 gm or less born over the period of one year. Dilated fundus examination ofall babies was done by indirect ophthalmoscopy between 2-4 weeks after birth and followed up tillthe retinal vascularization was complete. Classifi cation of ROP was done according to internationalclassifi cation (ICROP). Maternal and neonatal risk factors were also noted.A total of 55 babies fulfi lled the screening criteria. ROP was present in 25.45% (n=14) of the babies.Threshold disease was noted in 5.45% (n=3) of the babies screened. Low birth weight (p<0.01)and low gestational age (p<0.01) was signifi cantly associated with the incidence of ROP. Oxygensupplementation (p=<0.01) was an independent risk factor.ROP screening should be performed in all preterm low birth weight infants where there is availabilityof good neonatal intensive care units. The examination should be intensifi ed in those having riskfactors like oxygen. Further studies in the other tertiary care hospitals in Nepal would help toestablish the screening criteria for Nepalese infants.Key words: Retinopathy of prematurity, Eastern Nepal, screening

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Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311789 ◽

2018 ◽

Vol 102 (12) ◽

pp. 1711-1716 ◽

Cited By ~ 19

Author(s):

Ahmet Yagmur Bas ◽

Nihal Demirel ◽

Esin Koc ◽

Dilek Ulubas Isik ◽

İbrahim Murat Hirfanoglu ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care ◽

Intensive Care Units ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Late Onset ◽

Relative Weight ◽

Neonatal Intensive Care Units ◽

Screening Criteria ◽

Prospective Multicentre Study

BackgroundTo evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition.MethodsA prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)≤1500 g or gestational age (GA)≤32 weeks and those with a BW>1500 g or GA>32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses.ResultsThe TR-ROP study included 6115 infants: 4964 (81%) with a GA≤32 weeks and 1151 (19%) with a GA>32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW≤1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW≤1500 g. Sixty-six (16%) of the treated infants did not fulfil the Early Treatment for Retinopathy of Prematurity requirements for treatment.ConclusionsScreening of infants with a GA≤34 weeks or a BW<1700 g appears to be appropriate in Turkey. Monitoring standards of neonatal care and conducting quality improvement projects across the country are recommended to improve neonatal outcomes in Turkish NICUs.Trial registration numberNCT02814929, Results.

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