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 Incidence and Characteristics of Infants with Retinopathy of Prematurity in Croatia

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. 

Effect of Intravitreal Aflibercept on Central Retinal Arterial Blood Flow in Type 1 Retinopathy of Prematurity

2017 ◽  
Vol 27 (6) ◽  
pp. 751-755 ◽  
Author(s):  
Emine A. Sukgen ◽  
Gökhan Söker ◽  
Yusuf Koçluk ◽  
Bozkurt Gülek
Keyword(s):  
Blood Flow ◽  
Retinopathy Of Prematurity ◽  
Color Doppler ◽  
Color Doppler Imaging ◽  
Doppler Imaging ◽  
Intravitreal Aflibercept ◽  
Retinal Artery ◽  
The Mean ◽  
Type 1 Rop

Purpose To evaluate the blood flow changes of the central retinal artery measured with color Doppler imaging (CDI) in infants receiving intravitreal aflibercept (IVA) for treatment of type 1 retinopathy of prematurity (ROP). Methods Patients with type 1 ROP were assessed prospectively by CDI following IVA. Color Doppler imaging was used to measure the peak systolic velocity, end diastolic velocity (EDV), pulsatility index (PI), and resistivity index (RI) of the central retinal artery (CRA) before IVA injection and 1 hour, 1 week, and 1 month after injection. Results A total of 29 eyes of 15 infants were included in this study. The mean gestational age at birth was 28.62 ± 2.48 weeks and the mean birthweight was 1,198.62 ± 348.99 g. All treated eyes showed complete regression of ROP and peripheral retinal vascularization continued. Measurements of EDV-CRA, RI-CRA, and PI-CRA showed significant changes after IVA treatment. Conclusions This study showed that IVA is an effective treatment for type 1 ROP. After IVA treatment, vascular resistance increases, ocular blood flow decreases, and changes in hemodynamic parameters of CRA may remain for a month. Further studies are needed to evaluate the effect of anti-vascular endothelial growth factor agents on ocular hemodynamics in infants with ROP.

scholarly journals Incidence, timing and risk factors of type 1 retinopathy of prematurity in a North American cohort

2020 ◽  
pp. bjophthalmol-2020-317467
Author(s):  
Yinxi Yu ◽  
Lauren A Tomlinson ◽  
Gil Binenbaum ◽  
Gui-shuang Ying
Keyword(s):  
Risk Factors ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Characteristic Curve ◽  
Time Windows ◽  
Secondary Analysis ◽  
Prenatal Factors ◽  
The Mean ◽  
Type 1 Rop

Background/AimsEarly detection and timely treatment of type 1 retinopathy of prematurity (ROP) can reduce the risk of blindness. To evaluate the incidence, timing and risk factors of type 1 ROP in a large, broad-risk cohort of premature infants.MethodsSecondary analysis of data from the two Postnatal Growth and Retinopathy of Prematurity studies. Main outcomes are the incidence and timing of type 1 ROP.ResultsAmong 11 463 infants (mean birth weight (BW), 1095 g; mean gestational age (GA), 28 weeks), 677 (5.9%, 95% CI 5.5% to 6.3%) developed type 1 ROP. Rate of type 1 ROP decreased with larger GA (28.8% for GA ≤23 weeks, 0.2% for GA of 31–32 weeks) and no infants with GA >32 weeks developed type 1 ROP. Type 1 ROP was first diagnosed at a median postmenstrual age (PMA) of 36 weeks (range 30–46 weeks) or postnatal age (PNA) of 11 weeks (range 5–21 weeks). The mean PMA at diagnosis of type 1 ROP increased with GA (35 weeks for GA of 22–24 weeks, 41 weeks for GA of 29–30 weeks), but the mean PNA at diagnosis of type 1 ROP was similar (11–13 weeks) across GA of 22–29 weeks. GA and BW dominate the association (area under the receiver operating characteristic curve=0.87, 95% CI 0.86 to 0.88).ConclusionsType 1 ROP developed in about 6% of premature infants over wide time windows in terms of both PMA and PNA. BW and GA are the dominant risk factors for type 1 ROP, while other prenatal factors add minimal predictive power for type 1 ROP.

Refractive Error in Patients with Retinopathy of Prematurity after Laser Photocoagulation or Bevacizumab Monotherapy

2015 ◽  
Vol 234 (4) ◽  
pp. 211-217 ◽  
Author(s):  
Hsi-Kung Kuo ◽  
I-Ting Sun ◽  
Mei-Yung Chung ◽  
Yi-Hao Chen
Keyword(s):  
Refractive Error ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Group 4 ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Type 1 Rop ◽  
Group 1

Purpose: To evaluate the refractive development of premature infants with retinopathy of prematurity (ROP) after treatment with laser photocoagulation or intravitreal injection of bevacizumab (IVB). Methods: The medical records of patients with ROP treated between 2003 and 2012 who underwent yearly follow-ups were retrospectively reviewed. Patients with residual ROP abnormalities were excluded. The cycloplegic refraction at 3 years of age, assessed using an autorefractometer, was recorded. Results: In total, 54 eyes from 54 patients were enrolled. Patients were divided into 4 groups: group 1, including 14 eyes of 14 patients treated with laser therapy; group 2, 15 eyes of 15 patients treated with IVB; group 3, 13 eyes of 13 patients with non-type 1 ROP under conservative follow-up, and group 4, 12 eyes of 12 premature patients without ROP. The mean spherical equivalent at 3 years of age was -1.71 ± 1.27 dpt in group 1, -1.53 ± 2.20 dpt in group 2, 0.63 ± 1.37 dpt in group 3, and 0.41 ± 1.95 dpt in group 4. The mean refractive error differed significantly among the 4 groups (p < 0.001). Patients in groups 1 and 2 were more prone to myopia compared with those in groups 3 and 4. Furthermore, patients with type 1 ROP treated by laser photocoagulation (group 1) and those treated by IVB (group 2) had similar refraction (p = 1). Conclusions: The results of this study suggest that treatment-demanding ROP eyes are susceptible to more severe myopia with age compared with eyes without ROP or those with spontaneously regressed ROP. In addition, the myopic status between laser and IVB treatment did not differ statistically.

INTRAVITREAL RANIBIZUMAB INJECTION AS TREATMENT IN PATIENTS WITH TYPE 1 RETINOPATHY OF PREMATURITY

2021 ◽  
pp. 13-15
Author(s):  
Kalishankar Das ◽  
Athokpam Poireiton ◽  
Sneha Bhowmick
Keyword(s):  
Cohort Study ◽  
Intravitreal Injection ◽  
Retinopathy Of Prematurity ◽  
Positive Response ◽  
Primary Treatment ◽  
Intravitreal Ranibizumab ◽  
Response Group ◽  
Type 1 Rop

Aim: To investigate the anatomic outcomes of patients treated with intravitreal ranibizumab in the treatment of type 1 retinopathy of prematurity (ROP). A prospective cohort study was done including 100 eyes of Material And Method: 60 patients with type 1 ROP treated with intravitreal injection of ranibizumab (IVR) (0.25 mg/ 0.025 ml) as primary treatment from June 2018 to November 2019 over a period of 18 months. The anatomic outcomes were analyzed and follow-up were done upto 6 months. There were a Result: total of 94 eyes (94.0%) in the positive response group and 6 eyes (6.0%) in the negative/no response group after IVR. Within the positive response group, 49 eyes (52.13%) were in the regression without laser subgroup, and 45 eyes (47.87%) were in the regression with laser subgroup. Conclusion: Intravitreal injection of ranibizumab seemed to be effective in treating patients with type 1 ROP.

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 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.

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

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.

scholarly journals Risk Factors for Retinopathy of Prematurity in the Netherlands: A Comparison of Two Cohorts

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Kasia Trzcionkowska ◽  
Floris Groenendaal ◽  
Peter Andriessen ◽  
Peter H. Dijk ◽  
Frank A.M. van den Dungen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
The Netherlands ◽  
Retinopathy Of Prematurity ◽  
Screening Guideline ◽  
Potential Risk Factors ◽  
Second Period ◽  
Perinatal Database ◽  
Rop Screening

<b><i>Introduction:</i></b> Retinopathy of prematurity (ROP) remains an important cause for preventable blindness. Aside from gestational age (GA) and birth weight, risk factor assessment can be important for determination of infants at risk of (severe) ROP. <b><i>Methods:</i></b> Prospective, multivariable risk-analysis study (NEDROP-2) was conducted, including all infants born in 2017 in the Netherlands considered eligible for ROP screening by pediatricians. Ophthalmologists provided data of screened infants, which were combined with risk factors from the national perinatal database (Perined). Clinical data and potential risk factors were compared to the first national ROP inventory (NEDROP-1, 2009). During the second period, more strict risk factor-based screening inclusion criteria were applied. <b><i>Results:</i></b> Of 1,287 eligible infants, 933 (72.5%) were screened for ROP and matched with the Perined data. Any ROP was found in 264 infants (28.3% of screened population, 2009: 21.9%) and severe ROP (sROP) (stage ≥3) in 41 infants (4.4%, 2009: 2.1%). The risk for any ROP is decreased with a higher GA (odds ratio [OR] 0.59 and 95% confidence interval [CI] 0.54–0.66) and increased for small for GA (SGA) (1.73, 1.11–2.62), mechanical ventilation &#x3e;7 days (2.13, 1.35–3.37) and postnatal corticosteroids (2.57, 1.44–4.66). For sROP, significant factors were GA (OR 0.37 and CI 0.27–0.50), SGA (OR 5.65 and CI 2.17–14.92), postnatal corticosteroids (OR 3.81 and CI 1.72–8.40), and perforated necrotizing enterocolitis (OR 7.55 and CI 2.29–24.48). <b><i>Conclusion:</i></b> In the Netherlands, sROP was diagnosed more frequently since 2009. No new risk factors for ROP were determined in the present study, apart from those already included in the current screening guideline.

Retinopathy of Prematurity—Using Electronic Medical Records to Efficiently Follow Patients at Multiple Hospitals

2021 ◽  
pp. 097321792110076
Author(s):  
Gwendolyn Schultz ◽  
Majida Gaffar
Keyword(s):  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Transitional Period ◽  
Neonatal Intensive Care Units ◽  
American Academy Of Pediatrics ◽  
Time Period ◽  
Cost Efficient ◽  
Delay Of Care ◽  
Physician Scheduling ◽  
Rop Screening

Purpose: To report the use of a centralized electronic medical record (EMR) to provide timely retinopathy of prematurity (ROP) screening in a previously fragmented monitoring system in a standalone children’s hospital in Connecticut. Methods: A chart review of 306 visits for ROP screening in 3 neonatal intensive care units (NICUs) over a time period of 24 months. Results: All infants born at <30 weeks gestational age or birth weight <1,500g (N = 107) at these NICUs were screened for ROP according to the American Academy of Pediatrics guidelines. Data was collected before the implementation of our centralized EMR list, during a transitional period, and once the list was established. Our analysis of the data found an improvement in delay of care from 16.85% to 10.83% of visits, and a decrease in number of visits done during off hours from 20.4% to 5% of visits. Conclusion: Our tool was a free and cost-efficient centralization of a once difficult-to-manage process for ROP screenings in Connecticut. The decrease in delay of care and improvement in physician scheduling will lead to better outcomes for our patients and better sustainability of practice for our providers.

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