Identification of treatment-warranted retinopathy of prematurity by neonatal nurse specialist

2021 ◽  
pp. fetalneonatal-2021-322266
Author(s):  
Janette Ravelo ◽  
Gillian Adams ◽  
Shahid Husain
Keyword(s):  
Sensitivity And Specificity ◽  
Retinopathy Of Prematurity ◽  
Imaging System ◽  
Nurse Specialist ◽  
Wide Field ◽  
Gestation Age ◽  
Screening Services ◽  
The Mean ◽  
Agreement Study ◽  
Rop Screening

ObjectiveTo determine the accuracy in the identification of infants with treatment-warranted retinopathy of prematurity (ROP) by a trained and experienced ROP neonatal nurse specialist compared with skilled ophthalmologists.MethodsA single-centre, prospective, blinded, agreement study was performed on a cohort of infants undergoing ROP screening. An experienced ROP neonatal nurse specialist obtained retinal images using a wide field digital retinal imaging system (WFDRI) on 127 infants and identified those with treatment-warranted ROP. This interpretation was compared with the interpretation of the same images by skilled ophthalmologists. The accuracy of the ROP nurse specialist’s interpretation was assessed for sensitivity and specificity compared with the gold standard interpretation by the ophthalmologists.ResultsThe ROP nurse specialist performed 345 ROP screens on both eyes of 127 infants. The mean (SD) gestation age (weeks) and birth weight (g) of the infants screened was 26.8 (2.8) and 929 (327), respectively. The nurse specialist correctly identified all 8 infants with treatment-warranted ROP and 118/119 infants without. The sensitivity and specificity (95% CI) of ROP screening episodes were 100% (63% to 100%) and 99.7% (98.4% to 100.0%), respectively.ConclusionA trained and experienced ROP neonatal nurse specialist can correctly identify infants with treatment-warranted ROP using WFDRI. Further work is required to examine the generalisability of this finding and its impact on ROP screening services.

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

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.

scholarly journals Haemoglobin Levels in Early Life among Infants with and without Retinopathy of Prematurity

2021 ◽  
Vol 18 (13) ◽  
pp. 7054
Author(s):  
Edwin Pheng ◽  
Zi Di Lim ◽  
Evelyn Tai Li Min ◽  
Hans Van Rostenberghe ◽  
Ismail Shatriah
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Analysis Of Covariance ◽  
Postnatal Life ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Main Component ◽  
Rop Screening

Retinopathy of prematurity (ROP) is a proliferative retinal vascular disorder attributed to an ischaemic stimulus in preterm infants. Haemoglobin, the main component for oxygen transportation, may be implicated in ROP development. This retrospective study compared the mean weekly haemoglobin levels between infants with and without ROP over the first six weeks of life. Premature infants of less than 32 weeks gestational age and less than 1.5 kg birth weight were grouped into age and birth weight-matched ROP cases and controls. Weekly mean haemoglobin levels were documented. An independent t-test was used to analyze the difference in mean haemoglobin levels between infants with ROP and infants without ROP. Adjustment for confounders was performed using one-way analysis of covariance. There was a statistically significant difference in adjusted mean haemoglobin levels between the ROP and non-ROP group during the first week of life (p = 0.038). No significant intergroup differences were observed at the other weeks. Haemoglobin monitoring during the first week of postnatal life may be useful to guide ROP screening in premature infants.

scholarly journals Survey of current retinopathy of prematurity practices in China

2021 ◽  
Vol 14 (8) ◽  
pp. 1241-1247
Author(s):  
Thao Phuong Le ◽  
◽  
Leona Ding ◽  
Rong Hu ◽  
Xiao-Bo Lou ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Fundus Photography ◽  
Future Research ◽  
Treatment Preferences ◽  
Wide Field ◽  
Screening Criteria ◽  
Anti Vegf ◽  
Research And Education ◽  
Endothelial Growth Factor ◽  
Rop Screening

AIM: To understand retinopathy of prematurity (ROP) screening and treatment preferences among Chinese ophthalmologists. METHODS: A Chinese language survey was administered anonymously using WebQ (Catalyst, Seattle, WA, USA) among Chinese ROP screeners from December 2016 to January 2017. RESULTS: Among 70 ophthalmologists contacted, 65 responded (93%; 78% female, mean age 40y, 57% pediatric ophthalmologists and 25% retina specialists). Most used screening criteria of birth weight ≤2 kg (62%) with variation in cut-off gestational age (≤37wk, 34%; ≤34wk, 22%; ≤32wk, 31%). RetCam (Natus Medical Incorporated, Pleasanton, CA, USA) wide-field fundus photography assisted most screeners (72%) and was exclusively used by many (29%). Among 55 ophthalmologists treating ROP, anti-vascular endothelial growth factor (VEGF) was preferred over laser for both zone I (76% vs 24%) and zone II ROP (58% vs 42%). Retina specialists (P=0.004) and ophthalmologists with >3mo of training (P=0.03) were more likely to use anti-VEGF over laser for zone I ROP. Lack of laser training (8/20, 40%), access (6/20, 30%) and anesthesia (4/20, 20%) were common barriers to laser treatment. CONCLUSION: Chinese ROP screeners favor anti-VEGF injection and RetCam imaging for ROP management. A better understanding of ROP screening and treatment informs future research and education efforts in China.

The validity of telemedicine-based screening for retinopathy of prematurity in the Premature Eye Rescue Program in Hungary

2019 ◽  
pp. 1357633X1988011 ◽  
Author(s):  
Erika Maka ◽  
Gábor Kovács ◽  
László Imre ◽  
Clare Gilbert ◽  
Miklós Szabó ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Nurse Practitioners ◽  
Retinopathy Of Prematurity ◽  
Digital Imaging ◽  
Lower Sensitivity ◽  
Second Phase ◽  
Neonatal Transport ◽  
Group A ◽  
Group B ◽  
Rop Screening

Purpose To assess the validity of wide-field digital imaging (WFDI) and telemedicine-based screening compared with examination by binocular indirect ophthalmoscopy (BIO) and to present some of the results from the first five years of telemedicine-based screening in the Premature Eye Rescue Program in Hungary. Methods We performed a retrospective analysis in two periods that aimed to assess (a) the validity of retinal digital imaging and (b) routine bedside screening. The validity was assessed in two neonatal intensive care units (NICUs), one in the First Department of Paediatrics and the other in the Second Department of Obstetrics and Gynaecology, Semmelweis University. The telemedicine-based WFDI (WFDI-TM) screening program was introduced in two phases. In the first phase (from 30 November 2009 to 8 August 2010), BIO and WFDI were performed by the same paediatric ophthalmologist (Group A). In the second phase (from 9 August 2010 to 29 March 2011), BIO was performed by the paediatric ophthalmologist, while retinal images were captured by a trained neonatal transport nurse practitioner (Group B). BIO screening was the reference method as a gold standard in both phases. Results During the validity assessment period 634 examinations were performed in 153 preterm infants. Overall, 76 babies were screened in Group A and 80 were screened in Group B. We found lower sensitivity and specificity in cases of any ROP (sensitivity 86%, specificity 99%) compared with those of treatment-requiring retinopathy of prematurity (TR-ROP) (both sensitivity and specificity 100%). In the Premature Eye Rescue Program between 1April 2011 and 31 March 2016, we used WFDI in 3035 infants (4589 procedures). Over this five-year period, 100 (9.6%) infants were treated by laser, and no child who received care in any of the Semmelweis University NICUs became blind from ROP. Conclusions (a) WFDI-TM ROP screening is a useful and efficient approach, although it cannot completely replace BIO; (b) no ROP-related blindness developed among the screened preterm babies; and (c) WFDI-TM ROP screening can be implemented in the logistics of a neonatal emergency and ambulance team infrastructure with neonatal transport nurse practitioners as ‘photographers’.

Validation of the postnatal growth and retinopathy of prematurity screening criteria: A retrospective Italian analysis

2021 ◽  
pp. 112067212110113
Author(s):  
Samuele Caruggi ◽  
Matteo Scaramuzzi ◽  
Maria Grazia Calevo ◽  
Enrico Priolo ◽  
Lorenza Sposetti ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Sensitivity And Specificity ◽  
Retinopathy Of Prematurity ◽  
Postnatal Growth ◽  
Detection Sensitivity ◽  
Screening Criteria ◽  
Screening Protocol ◽  
Type 1 Rop ◽  
Rop Screening

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.

scholarly journals Oral Sucrose Improves Analgesia During Retinopathy of Prematurity Screening

2021 ◽  
Author(s):  
Ryan R Ramoutar ◽  
Anil J Singh ◽  
Charikleia Papandreou
Keyword(s):  
Retinopathy Of Prematurity ◽  
Screening Methods ◽  
Infant Pain ◽  
The Mean ◽  
Oral Sucrose ◽  
Group 2 ◽  
Pipp Score ◽  
Topical Analgesia ◽  
Rop Screening ◽  
Group 1

Abstract Purpose To determine whether sucrose provides significant analgesia during Retinopathy of Prematurity (ROP) screening Methods This was a prospective, randomized, sinlge masked audit. The examinations were performed by a single examiner. Forty-five (45) neonates were separated into two groups; Group 1 received oral sucrose while Group 2 received oral sucrose and non-nutritive suckling (NNS) at the discretion of the attending nurse. Pain was assessed using the Premature Infant Pain Profile (PIPP) score and recorded at baseline, immediately following lid speculum, at 3 minutes and 6 minutes following lid speculum insertion. Results The mean baseline PIPP score was 0.5. Fifteen (15) neonates (33%) received NNS. The mean PIPP scores at speculum insertion in both groups (Group 1: 7.24, Group 2: 5.50) were observed to be higher than at baseline and lower in Group 2 than in Group 1. In both groups, the scores at 3 minutes (Group 1: 4.70, Group 2: 4.20) and 6 minutes (Group 1 4.50, Group 2: 4.70) were observed to be higher than at baseline, lower than at speculum insertion, but not significantly different to each other. Conclusions Lid speculum insertion during ROP screening appears to be a significantly painful event. ROP examinations should be conducted with a combination of topical analgesia and sucrose and NNS for greatest pain-relieving effect.

scholarly journals Retinopathy of prematurity: incidence report of outliers based on international screening guidelines

2019 ◽  
Vol 5 (S1) ◽  
Author(s):  
Juan Carlos Romo-Aguas ◽  
Ana González-H.León ◽  
Miroslava Paolah Meraz-Gutiérrez ◽  
María A. Martínez-Castellanos
Keyword(s):  
At Risk ◽  
Birth Weight ◽  
American Academy ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Retrospective Review ◽  
Selection Criteria ◽  
Screening Guidelines ◽  
The Mean ◽  
Rop Screening

Abstract Aim The objective of this study is to report the incidence of retinopathy of prematurity (ROP) outliers that fall outside the screening guidelines of the American Academy of Ophthalmology (AAO) in our country. Methods A retrospective review of 503 records of newborns evaluated in our institution between January 2011 and March 2017. We analyzed the data by subgroups based on gestational age (GA), birth weight (BW) and stage, focusing on the outliers that don’t meet the criteria of the screening AAO guidelines (GA ≤ 30 weeks, BW ≤ 1500 g). Results Of the 503 records, 352 had some degree of ROP, 91.76% being bilateral, and 26.2% require treatment. The mean GA at delivery was 30.56 ± 2.33 weeks, and the mean BW was 1287.90 ± 338.52 g. For the current AAO/AAP ROP screening, 19.9% were outliers, of which (57%) had ROP diagnosis and (38%) required treatment. Conclusions ROP diagnosis in newborns of BW > 1500 g or GA > 30 weeks is not uncommon in Mexico, and it is important to take this into account to adjust the selection criteria on each population to reach all the infants at risk.

scholarly journals Screening for Retinopathy of Prematurity Through Utilization a Pediatric Retinal Camera at Jim Pattison Children’s Hospital: A Vision for Improved Care

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110396
Author(s):  
Malshi Karunatilake ◽  
Sibasis Daspal ◽  
Veronica Mugarab Samedi ◽  
Shehla Rubab
Keyword(s):  
Birth Weight ◽  
Early Detection ◽  
Disease Severity ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Retinal Imaging ◽  
Wide Field ◽  
Children's Hospital ◽  
Rop Screening

Retinopathy of Prematurity (ROP) is a vascular proliferative disorder of preterm infants, with increased disease severity and incidence occurring with lower gestational age and birth weight. An alternate approach to ROP screening with wide-field digital retinal imaging helps with the early detection of ROP, especially during the pandemic.

scholarly journals A Prospective Study of the Incidence of Retinopathy of Prematurity in China: Evaluation of Different Screening Criteria

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Qiuping Li ◽  
Zonghua Wang ◽  
Ruijuan Wang ◽  
Hongyi Tang ◽  
Haihua Chen ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
The United States ◽  
Epidemiologic Studies ◽  
Type I ◽  
Screening Criteria ◽  
The Mean ◽  
The Uk ◽  
A Prospective Study ◽  
Rop Screening

To investigate the incidence of Retinopathy of Prematurity (ROP) in Beijing, North China, and to evaluate the effectiveness of different ROP screening criteria, we conducted a prospective cohort study in a single-neonatal intensive care unit (NICU). A total of 2997 premature infants with birth weight (BW) ≤ 2000 g and/or gestational age (GA) ≤ 34 weeks had completed ROP screening. ROP was diagnosed in 356 (11.9%) infants. The mean GA was 30.46 ± 1.98 weeks and the mean BW was 1477.35 ± 371.29 g. Of the 59 (2.0%) infants receiving treatment, the mean GA was 29.37 ± 2.10 weeks, and the mean BW was 1240.80 ± 330.71 g. The incidence of ROP declined from 14.7% in 2009 and 11.1% in 2010 to 9.5% in 2011. The United Kingdom (UK) criteria could reduce the screening number by 40.8%, and 3 infants with type I ROP needing treatment were missed, but none in 2011. The United States (US) criteria could reduce the screening number by 66.5%, and 10 infants with type I ROP needing treatment were missed, including one in 2011. So the UK criteria may be appropriate for screening of ROP in our NICU in 2011. Future multisite epidemiologic studies are required to establish suitable ROP screening criteria in China.

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