1
|
Aulakh S, Houtman AC, Rathod D, Biswas S, McLoone E, Shafiq AE, Nassar MM, Connor AJ, Hillier RJ. The Royal College of Paediatrics and Child Health Retinopathy of Prematurity Screening Guidelines (2022): a series of treated infants falling outside the updated criteria. Eye (Lond) 2024; 38:2557-2560. [PMID: 38658679 PMCID: PMC11384725 DOI: 10.1038/s41433-024-03076-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 03/12/2024] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND/OBJECTIVES Screening for retinopathy of prematurity (ROP) is a core healthcare intervention in premature babies to avoid preventable sight loss. A variety of screening criteria are in place globally for this purpose. The Royal College of Paediatrics and Child Health recently updated the United Kingdom ROP screening guidelines (March 2022). A key change was the reduction in the gestational age (GA) to warrant retinal screening (from 32 to 31 weeks). SUBJECTS/METHODS In the course of informal national surveillance during guideline development (2017-2022) and soon after, babies under our care falling outside the updated screening criteria who underwent treatment for ROP were identified. A retrospective case review was carried out. RESULTS Six babies were identified as having undergone screening and treatment, prior to implementation of the new guidance. Screening and treatment would have been forfeited as per the March 2022 guidelines. All six had numerous systemic risk factors for developing ROP. Specifically, all had documented poor postnatal weight gain. CONCLUSIONS We present this case series to bring forth an urgent discussion amongst key stakeholders as to whether the new guidance, as it stands, is safe and fit for purpose.
Collapse
Affiliation(s)
| | - Anne Cees Houtman
- Royal Hospital for Children, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Dinesh Rathod
- Swansea Bay University Health Board, Port Talbot, UK
| | - Susmito Biswas
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Eibhlin McLoone
- Royal Victoria Hospital, Belfast Trust and Social Care Trust, Belfast, UK
| | - Ayad E Shafiq
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - Mahmoud M Nassar
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - Alan J Connor
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - Roxane J Hillier
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK.
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
| |
Collapse
|
2
|
Kaya-Guner E, Inci-Bozbiyik D, Kefeli-Demirel M. Retrospective cohort evaluation of postnatal growth and retinopathy of prematurity (G-ROP) criteria in a tertiary centre in Turkey. Acta Ophthalmol 2024; 102:e712-e717. [PMID: 38156483 DOI: 10.1111/aos.16622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
PURPOSE The postnatal growth and retinopathy of prematurity (G-ROP) study has proposed a new model to increase the effectiveness of screening retinopathy of prematurity (ROP). The present study aimed to evaluate the effectiveness of the G-ROP model in a tertiary centre in Turkey. METHODS The medical records of infants screened for ROP in our hospital between January 2018 and December 2022 were reviewed retrospectively. Babies with a documented ROP result and regular body weight measurements up to the 40th day of life were included in the study, and the G-ROP model was applied. The sensitivity of the G-ROP prediction model in detecting treated ROP, Type 1 ROP, Type 2 ROP, and low-grade ROP and the reduction in the number of babies to be screened by applying the model were calculated. RESULTS The G-ROP model was applied to a total of 242 infants. While 194 babies were determined for screening, 22 of them were treated. The sensitivity to predict treated ROP was 100%, and the specificity was 21.8%. The model successfully predicted all cases of Type 1 ROP in the cohort, while the sensitivity was 90.9% for Type 2 ROP and 90.7% for low-grade ROP. The G-ROP model reduced the number of infants requiring screening by 19.8% in our study. CONCLUSIONS The G-ROP model was successfully validated in our cohort in detecting treated ROP and Type 1 ROP, reducing the number of infants requiring screening by approximately 1 in 5.
Collapse
Affiliation(s)
- Emine Kaya-Guner
- Department of Ophthalmology, Health Sciences University Izmir Tepecik Research and Training Hospital, Izmir, Turkey
| | - Duygu Inci-Bozbiyik
- Department of Ophthalmology, Health Sciences University Izmir Tepecik Research and Training Hospital, Izmir, Turkey
| | - Melike Kefeli-Demirel
- Department of Neonatalogy, Health Sciences University Izmir Tepecik Research and Training Hospital, Izmir, Turkey
| |
Collapse
|
3
|
Souverein EA, Siegel BA, Siegel LM, Reid MW, Lee TC, Nallasamy S. Initiation of retinopathy of prematurity screening examinations in extremely premature infants. J AAPOS 2024; 28:103956. [PMID: 38878959 DOI: 10.1016/j.jaapos.2024.103956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/26/2024] [Accepted: 03/21/2024] [Indexed: 07/07/2024]
Abstract
PURPOSE To determine whether extremely premature infants require screening for retinopathy of prematurity (ROP) if <31 weeks' postmenstrual age (PMA). METHODS The medical records of infants born in community hospital settings at <31 weeks' gestational age (GA) were reviewed retrospectively. Prevalence and progression of ROP in infants born at <24 weeks' GA were compared with infants born at 24-30 weeks' GA. RESULTS A total of 2,061 records were reviewed: 1,969 infants were born at 24-30 weeks' GA; 92, at <24 weeks. Infants born <24 weeks' GA were more likely to develop pre-plus and plus disease or require treatment than infants born 24-30 weeks' GA (P < 0.0001) and did so earlier (P = 0.0001). Eight infants developed pre-plus or greater ROP <31 weeks' PMA; 6 were born <24 weeks' GA. Three infants developed plus disease or required treatment <31 weeks' PMA, the earliest at 27 and 3/7 weeks. CONCLUSIONS Clinicians should consider initiating ROP screening examinations before 31 weeks' PMA, particularly for infants born <24 weeks' GA and those with lower birth weights.
Collapse
Affiliation(s)
- Erik A Souverein
- Keck School of Medicine of University of Southern California, Los Angeles, California
| | | | - Lance M Siegel
- Children's Eye Institute, Upland, California; The Vision Center, Children's Hospital Los Angeles, Los Angeles, California
| | - Mark W Reid
- The Vision Center, Children's Hospital Los Angeles, Los Angeles, California
| | - Thomas C Lee
- The Vision Center, Children's Hospital Los Angeles, Los Angeles, California; USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Sudha Nallasamy
- The Vision Center, Children's Hospital Los Angeles, Los Angeles, California; USC Roski Eye Institute, Keck School of Medicine of University of Southern California, Los Angeles, California.
| |
Collapse
|
4
|
Fenton TR, Merlino Barr S, Elmrayed S, Alshaikh B. Expected and Desirable Preterm and Small Infant Growth Patterns. Adv Nutr 2024; 15:100220. [PMID: 38670164 PMCID: PMC11251411 DOI: 10.1016/j.advnut.2024.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Adequate nutrition is necessary for achieving optimal growth and neurodevelopment. Growth is a natural and expected process that happens concomitantly with rapid advancements in neurodevelopment. Serial weight, length, and head circumference growth measures are essential for monitoring development, although identifying pathological deviations from normal growth can pose challenges. Appropriate growth assessments require considerations that a range of sizes for length, head circumference, and weight are expected and appropriate. Because of genetic differences and morbidities, there is a considerable overlap between the growth of healthy infants and those with growth alterations. Parents tend to be over-concerned about children who plot low on growth charts and often need reassurance. Thus, the use of terms such as "poor" growth or growth "failure" are discouraged when growth is approximately parallel to growth chart curves even if their size is smaller than specific percentiles. No specific percentile should be set as a growth goal; individual variability should be expected. An infant's size at birth is important information that goes beyond the common use of prognostic predictions of appropriate compared with small or large for gestational age. The lower the birthweight, the lower the nutrient stores and the more important the need for nutrition support. Compared to term infants, preterm infants at term-equivalent age have a higher percentage of body fat, but this diminishes over the next months. Current research findings support expert recommendations that preterm infants should grow, after early postnatal weight loss, similar to the fetus and then term-born infants, which translates to growth approximately parallel to growth chart curves. There is no need for a trade-off between optimum cognition and optimum future health. Each high-risk infant needs individualized nutrition and growth assessments. This review aims to examine infant growth expectations and messaging for parents of preterm and term-born infants within the broader causal framework.
Collapse
Affiliation(s)
- Tanis R Fenton
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | | | - Seham Elmrayed
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Institute of Global Health and Human Ecology, American University in Cairo, Egypt
| | - Belal Alshaikh
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| |
Collapse
|
5
|
Tayyab H, Choudhary RA, Jabbar H, Motiwala MA, Momin SNA, Hashmi S, Mirza A, Abid K. Validation of postnatal growth and retinopathy of prematurity (G-ROP) screening guidelines in a tertiary care hospital of Pakistan: A report from low-middle income country. PLoS One 2024; 19:e0302534. [PMID: 38722843 PMCID: PMC11081222 DOI: 10.1371/journal.pone.0302534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/05/2024] [Indexed: 05/13/2024] Open
Abstract
Retinopathy of Prematurity (ROP) significantly contributes to childhood blindness globally, with a disproportionately high burden in low- and middle-income countries (LMICs) due to improved neonatal care alongside inadequate ROP screening and treatment facilities. This study aims to validate the performance of Postnatal Growth and Retinopathy of Prematurity (G-ROP) screening criteria in a cohort of premature infants presenting at a tertiary care setting in Pakistan. This cross-sectional study utilized retrospective chart review of neonates admitted to the neonatal intensive care unit (NICU) at The Aga Khan University Hospital, Pakistan from January 2018 to February 2022. The complete G-ROP criteria were applied as prediction tool for infants with type 1 ROP, type 2 ROP, and no ROP outcomes. Out of the 166 cases, 125 cases were included in the final analysis, and remaining cases were excluded due to incomplete data. ROP of any stage developed in 83 infants (66.4%), of whom 55 (44%) developed type 1 ROP, 28 (22.4%) developed type 2 ROP, and 19 (15.2%) were treated for ROP. The median BW was 1060 gm (IQR = 910 to 1240 gm) and the median gestational age was 29 wk (IQR = 27 to 30 wk). The G-ROP criteria demonstrated a sensitivity of 98.18% (95% CI: 90.28-99.95%) for triggering an alarm for type 1 ROP. The G-ROP criteria achieved 100% sensitivity (95% CI: 87.66 to 100%) for type 2 ROP. The overall sensitivity of G-ROP criteria to trigger an alarm for any type of ROP was 98.8% (95% CI: 93.47 to 99.97%). Thus, the G-ROP screening model is highly sensitive in detecting at-risk infants for ROP in a Pakistani tertiary care setting, supporting its use in LMICs where standard screening criteria may not suffice.
Collapse
Affiliation(s)
- Haroon Tayyab
- Department of Ophthalmology and Visual Sciences, The Aga Khan University Hospital, Karachi, Pakistan
| | - Roha Ahmed Choudhary
- Clinical Research Fellow, Office of Dean, The Aga Khan University Hospital, Karachi, Pakistan
| | - Hassan Jabbar
- Department of Pediatrics, The Aga Khan University Hospital, Karachi, Pakistan
| | | | - Sehrish Nizar Ali Momin
- Department of Ophthalmology and Visual Sciences, The Aga Khan University Hospital, Karachi, Pakistan
| | - Shiraz Hashmi
- Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Adnan Mirza
- Department of Pediatrics, The Aga Khan University Hospital, Karachi, Pakistan
| | - Khadijah Abid
- Department of Ophthalmology and Visual Sciences, The Aga Khan University Hospital, Karachi, Pakistan
| |
Collapse
|
6
|
Johnson B, Makkar A, Sessler R, DeShea L, Siatkowski RM, Bhatti FN. Validation and Feasibility of the Postnatal Growth and Retinopathy of Prematurity Retinal Screening Criteria at a Level IV Tertiary Care Neonatal Intensive Care Unit. Am J Perinatol 2024; 41:e2376-e2382. [PMID: 37339675 DOI: 10.1055/a-2113-8733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
OBJECTIVE Retinopathy of prematurity (ROP) is detected in preterm infants by standardized screening programs, but in general, they have poor sensitivity. The Postnatal Growth and Retinopathy of Prematurity (G-ROP) algorithm uses weight gain to predict ROP superior reported sensitivity. Our objectives are to (1) independently validate the sensitivity of G-ROP criteria for the detection of ROP in infants born at >28 weeks' gestation in a tertiary care unit in the United States and (2) to calculate the cost savings associated with a potential reduction in examinations. STUDY DESIGN This is a retrospective analysis of retinal screening examination data, with post-hoc application of G-ROP criteria to determine whether G-ROP criteria had acceptable sensitivity and specificity in diagnosing Type 1 and Type 2 ROP. All infants born at >28 weeks who were screened by current American Academy of Pediatric Ophthalmologists/American Academy of Pediatrics guidelines at Oklahoma Children's Hospital at the University of Oklahoma Health Sciences Center, between 2014 and 2019, were included. Subset analysis of infants screened by second tier criteria was also performed. Potential cost savings were estimated by analyzing frequency of billing codes. And by calculating the number of infants who could have potentially been spared examination. RESULTS The G-ROP criteria had 100% sensitivity in detecting type 1 and 87.6% sensitivity in detecting type 2 ROP, which would have reduced infants screened by 50%. All infants in the second tier who would require treatment were detected. A cost saving of 49% was projected. CONCLUSION The G-ROP criteria are easy to apply in real-world setting, thus establishing feasibility. The algorithm identified all cases of type 1 ROP; however, some cases of type 2 ROP were not detected. The annual savings in hospital examination cost by using these criteria would be 50%. Therefore, G-ROP criteria can safely be used to screen for ROP and may reduce the number of unnecessary examinations. KEY POINTS · The G-ROP screening criteria are safe and predict 100% of treatment warranted ROP.. · Adoption of G-ROP criteria is feasible for level IV NICUs.. · Adoption of G-ROP screening guidelines will result in significant cost savings..
Collapse
Affiliation(s)
- Barbara Johnson
- Department of Pediatrics, Neonatal Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Abhishek Makkar
- Department of Pediatrics, Neonatal Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Rachel Sessler
- Department of Pediatrics, Neonatal Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Lise DeShea
- Department of Pediatrics, Neonatal Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - R Michael Siatkowski
- Department of Ophthalmology and Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Faizah N Bhatti
- Department of Pediatrics, Neonatal Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Department of Ophthalmology and Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| |
Collapse
|
7
|
Shipton C, Aitken J, Atkinson S, Burchmore R, Hamilton R, Mactier H, McGill S, Millar E, Houtman AC. Tear Proteomics in Infants at Risk of Retinopathy of Prematurity: A Feasibility Study. Transl Vis Sci Technol 2024; 13:1. [PMID: 38691083 PMCID: PMC11077915 DOI: 10.1167/tvst.13.5.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/25/2024] [Indexed: 05/03/2024] Open
Abstract
Purpose This feasibility study investigated the practicability of collecting and analyzing tear proteins from preterm infants at risk of retinopathy of prematurity (ROP). We sought to identify any tear proteins which might be implicated in the pathophysiology of ROP as well as prognostic markers. Methods Schirmer's test was used to obtain tear samples from premature babies, scheduled for ROP screening, after parental informed consent. Mass spectrometry was used for proteomic analysis. Results Samples were collected from 12 infants, which were all adequate for protein analysis. Gestational age ranged from 25 + 6 to 31 + 1 weeks. Postnatal age at sampling ranged from 19 to 66 days. One infant developed self-limiting ROP. Seven hundred one proteins were identified; 261 proteins identified in the majority of tear samples, including several common tear proteins, were used for analyses. Increased risk of ROP as determined by the postnatal growth ROP (G-ROP) criteria was associated with an increase in lactate dehydrogenase B chain in tears. Older infants demonstrated increased concentration of immunoglobulin complexes within their tear samples and two sets of twins in the cohort showed exceptionally similar proteomes, supporting validity of the analysis. Conclusions Tear sampling by Schirmer test strips and subsequent proteomic analysis by mass spectrometry in preterm infants is feasible. A larger study is required to investigate the potential use of tear proteomics in identification of ROP. Translational Relevance Tear sampling and subsequent mass spectrometry in preterm infants is feasible. Investigation of the premature tear proteome may increase our understanding of retinal development and provide noninvasive biomarkers for identification of treatment-warranted ROP.
Collapse
Affiliation(s)
| | | | - Samuel Atkinson
- University of Aberdeen, School of Medicine, Medical Sciences and Nutrition, Foresterhill, Aberdeen, Scotland, UK
| | - Richard Burchmore
- University of Glasgow, Wolfson Wohl Cancer Research Centre, Bearsden, Glasgow, Scotland, UK
| | - Ruth Hamilton
- Royal Hospital for Children, Glasgow, Glasgow, Scotland, UK
| | | | - Suzanne McGill
- University of Glasgow, Wolfson Wohl Cancer Research Centre, Bearsden, Glasgow, Scotland, UK
| | | | | |
Collapse
|
8
|
Sola A, Leslie Altimier, Teresa Montes Bueno M, Muñoz CE. Monitoring SpO 2: The Basics of Retinopathy of Prematurity (Back to Basics) and Targeting Oxygen Saturation. Crit Care Nurs Clin North Am 2024; 36:69-98. [PMID: 38296377 DOI: 10.1016/j.cnc.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
Oxygen (O2) is a drug frequently used in newborn care. Adverse effects of hypoxia are well known but the damaging effects of excess oxygen administration and oxidative stress have only been studied in the last 2 decades. Many negative effects have been described, including retinopathy of prematurity . Noninvasive pulse oximetry (SpO2) is useful to detect hypoxemia but requires careful evaluation and understanding of the frequently changing relationship between O2 and hemoglobin to prevent hyperoxemia. Intention to treat SpO2 ranges should be individualized for every newborn receiving supplemental O2, according to gestational age, post-natal age, and clinical condition.
Collapse
Affiliation(s)
- Augusto Sola
- Iberoamerican Society of Neonatology (SIBEN), 2244 Newbury Drive, Wellington, FL 3341, USA.
| | - Leslie Altimier
- Cardinal Glennon Children's Hospital, 1465 South Grand Avenue, St. Louis, MO 63104, USA
| | | | | |
Collapse
|
9
|
Moorthy S, Adams GGW, Smith G, Biswas S, Aliyan W, Bhudia R, Saiyed A, Husain S. Validation of the East London Retinopathy of Prematurity algorithm to detect treatment-warranted retinopathy of prematurity: a cohort study. Br J Ophthalmol 2024; 108:471-475. [PMID: 36759150 DOI: 10.1136/bjo-2022-322522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 01/21/2023] [Indexed: 02/11/2023]
Abstract
AIM To validate the East London Retinopathy of Prematurity algorithm (EL-ROP) in a cohort of infants at risk of developing retinopathy of prematurity (ROP). METHODS The EL-ROP algorithm was applied retrospectively to routinely collected data from two tertiary neonatal units in England on infants eligible for ROP screening. The EL-ROP recommendation, to screen or not, was compared with the development of treatment-warranted ROP (TW-ROP) for each infant. The main outcome measures were (1) EL-ROP's sensitivity for predicting the future development of TW-ROP and (2) potential to reduce ROP screening examinations. RESULTS Data from 568 infants were included in the trial. The median (IQR) birth weight (g) was 875 (704 - 1103) and gestational age (weeks) was 27.0 (25.4 - 29.0). Maternal ethnicity was black (33%) and non-black (67%). 58(10%) developed TW-ROP and in every case this was predicted by the EL-ROP algorithm. It's sensitivity was 100% (95% CI 94-100%) specificity: 44% (95% CI 39-48%) positive predictive value: 17% (95%CI 16-18%), negative predictive value: 100%. CONCLUSIONS EL-ROP has been validated in a cohort of infants from two tertiary neonatal units in England. Further validation is required before its clinical usefulness can be assessed.
Collapse
Affiliation(s)
- Sonia Moorthy
- Paediatric Ophthalmology and Strabismus, Moorfields Eye Hospital City Road Campus, London, UK
| | - Gillian G W Adams
- Paediatric Ophthalmology and Strabismus, Moorfields Eye Hospital City Road Campus, London, UK
| | - Graham Smith
- Data Analytics, Omnivide, Sydney, New South Wales, Australia
| | - Susmito Biswas
- Paediatric Ophthalmology, Manchester Royal Eye Hospital, Manchester, UK
| | - Waleed Aliyan
- Paediatric Ophthalmology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Roshni Bhudia
- Primary Care and Public Health, Imperial College London, London, UK
| | - Aamir Saiyed
- Emergency Department, Cardiff and Vale University Health Board, Cardiff, UK
| | - Shad Husain
- Neonatology, Homerton University Hospital Neonatal Unit, London, UK
| |
Collapse
|
10
|
Zhang L, Buonfiglio F, Fieß A, Pfeiffer N, Gericke A. Retinopathy of Prematurity-Targeting Hypoxic and Redox Signaling Pathways. Antioxidants (Basel) 2024; 13:148. [PMID: 38397746 PMCID: PMC10885953 DOI: 10.3390/antiox13020148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 02/25/2024] Open
Abstract
Retinopathy of prematurity (ROP) is a proliferative vascular ailment affecting the retina. It is the main risk factor for visual impairment and blindness in infants and young children worldwide. If left undiagnosed and untreated, it can progress to retinal detachment and severe visual impairment. Geographical variations in ROP epidemiology have emerged over recent decades, attributable to differing levels of care provided to preterm infants across countries and regions. Our understanding of the causes of ROP, screening, diagnosis, treatment, and associated risk factors continues to advance. This review article aims to present the pathophysiological mechanisms of ROP, including its treatment. Specifically, it delves into the latest cutting-edge treatment approaches targeting hypoxia and redox signaling pathways for this condition.
Collapse
Affiliation(s)
| | | | | | | | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (L.Z.); (F.B.); (A.F.); (N.P.)
| |
Collapse
|
11
|
Lyon J, Gagrani M, Hiasat JG, Eldib A, Pihlblad MS. Retrospective evaluation of Postnatal Growth and Retinopathy of Prematurity (G-ROP) and Colorado Retinopathy of Prematurity (CO-ROP) screening algorithms in University of Pittsburgh Medical Centers cohort. J AAPOS 2023; 27:289-291. [PMID: 37709192 PMCID: PMC10600575 DOI: 10.1016/j.jaapos.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/29/2023] [Accepted: 06/03/2023] [Indexed: 09/16/2023]
Abstract
Of the 70,000 infants screened for retinopathy of prematurity (ROP) each year in the United States, only 43% develop any ROP, and <10% develop treatment-requiring ROP. Investigators have tried to develop new methods for determining more specific screening criteria, including the Postnatal Growth and Retinopathy of Prematurity (G-ROP) and Colorado Retinopathy of Prematurity (CO-ROP), to reduce the number of infants being screened while maintaining a high degree of sensitivity. We evaluated the records of 138 premature infants who received treatment for ROP between 2010 and 2021 with respect to G-ROP (129 infants) and CO-ROP (102 infants) to test the sensitivity of each. Using the G-ROP criteria, 0.8% (1/129) of treated infants had type 1 ROP that would have been missed and 3.1% (4/129) of total infants treated were missed. These infants would not have been screened or received treatment if G-ROP guidelines were followed. Using the CO-ROP criteria, 2% (2/102) of treated infants had type 1 ROP that would have been missed and 4.9% (5/102) of total infants treated were missed. In our study cohort, both sets of criteria proved less sensitive than our current screening guidelines.
Collapse
Affiliation(s)
- John Lyon
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Meghal Gagrani
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jamila G Hiasat
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amgad Eldib
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Matthew S Pihlblad
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
| |
Collapse
|
12
|
Bunyavee C, Hemarat K. Accuracy of the postnatal growth and retinopathy of prematurity screening criteria in predicting prethreshold retinopathy of prematurity in the tertiary hospital, Bangkok, Thailand. Taiwan J Ophthalmol 2023; 13:535-539. [PMID: 38249513 PMCID: PMC10798389 DOI: 10.4103/tjo.tjo-d-23-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/23/2023] [Accepted: 05/01/2023] [Indexed: 01/23/2024] Open
Abstract
PURPOSE The postnatal growth and retinopathy of prematurity (G-ROP), retinopathy of prematurity (ROP) predictive model, was developed in North America with high sensitivity and fewer infants examined. This study aimed to validate this model in Thai infants by assessing sensitivity and comparing it to the current American Academy of Ophthalmology (AAO) screening guideline. MATERIALS AND METHODS The records of infants screened for ROP were retrospectively reviewed from 2015 to 2020. G-ROP model was applied to calculate sensitivity for prethreshold type 1 and 2 ROP and the reduction of the number of infants examined. RESULTS Of 129 infants screened, there were 102 infants who met G-ROP criteria. The mean gestational age at birth was 29.7 ± 2.7 weeks. The mean birth weight was 1177.8 ± 401.3 g. Both G-ROP and AAO detected prethreshold type 1 ROP in 24 of 24 infants (sensitivity, 100%; 95% confidence interval [CI], 85.8%-100%). Furthermore, they detected all four infants prethreshold type 2 ROP with 100% of sensitivity (95% CI, 39.8-100.0). The reduction in infants receiving examinations using G-ROP was 20.9%. CONCLUSIONS G-ROP model provided high sensitivity and lessen unnecessary examinations for ROP screening in Thai infants.
Collapse
Affiliation(s)
- Chavisa Bunyavee
- Department of Ophthalmology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Kornwipa Hemarat
- Department of Ophthalmology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| |
Collapse
|
13
|
Wang J, Ying GS, Yu Y, Tomlinson L, Binenbaum G. Racial Differences in Retinopathy of Prematurity. Ophthalmic Epidemiol 2023; 30:523-531. [PMID: 36647265 PMCID: PMC10349899 DOI: 10.1080/09286586.2023.2168014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE To delineate racial differences in the incidence and time course of ROP in a large cohort of premature infants. METHODS The secondary analysis of data from the two Postnatal Growth and ROP Studies (G-ROP-1 and G-ROP-2) that were collected in 41 hospitals in North America from 2006 to 2017. According to self-reported maternal race, premature infants were classified into 3 groups: White (N = 5580), Black (N = 3252), and Asian (N = 353). Incidence, severity, and time course of ROP; plus disease; and postnatal weight gain rate were compared among racial groups. RESULTS Black infants had significantly smaller BW (mean 1035 vs. 1131 vs.1144 grams, P < .001) and lower GA (28.2 vs. 28.6, vs. 29.1 weeks, P < .001) than White and Asian infants. However, Black infants had lower incidences of severe ROP (11.1% vs. 12.4% vs. 11.9%), ROP (42.1% vs. 43.2% vs. 30.6%), and plus disease (3.6% vs. 6.3%, vs. 5.9%) than White and Asian infants (BW and GA adjusted risk ratio for Black vs. White 0.69 for severe ROP, 0.83 for ROP, 0.44 for plus disease, all P < .0001). Mean daily-weight-gain on days of life 11-20 and 21-30 were similar across groups (P > .05), but lower in Black and Asian infants on days 31-40 (P < .001). There were no differences in the timing of severe ROP and ROP across racial groups. CONCLUSIONS Despite relatively lower GA, BW, and daily-weight-gain, Black preterm infants had lower incidences of ROP and plus disease than White preterm infants. The mechanisms for these differences require further investigation.
Collapse
Affiliation(s)
- Jingyun Wang
- State University of New York College of Optometry, New York, NY
| | - Gui-Shuang Ying
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA
| | - Yinxi Yu
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA
| | - Lauren Tomlinson
- Division of Ophthalmology, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Gil Binenbaum
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA
- Division of Ophthalmology, Children’s Hospital of Philadelphia, Philadelphia, PA
| |
Collapse
|
14
|
Raffa L, Alamri A, Alosaimi A, Alessa S, AlHarbi S, AlNowaiser S, Ahmedhussein H, Almarzouki H, Al Qurashi M. Jeddah Retinopathy of Prematurity (JED-ROP) Screening Algorithm. Glob Pediatr Health 2023; 10:2333794X231182524. [PMID: 37649556 PMCID: PMC10464887 DOI: 10.1177/2333794x231182524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/31/2023] [Indexed: 09/01/2023] Open
Abstract
Background. The Jeddah retinopathy of prematurity (JED-ROP) algorithm, which is more specific to the population in Saudi Arabia, was established to decrease the number of infants screened without missing type 1 ROP cases. Methods. The data reviewed were birth weight (BW), gestational age (GA), weekly postnatal weight gain (PWG), and relevant perinatal risk factors. The sensitivities and specificities for detecting type 1 ROP were calculated. Results. Of the 502 infants included in the study, 148 developed ROP. The JED-ROP algorithm demonstrated 100% sensitivity and 38.9% specificity for recommending the screening of infants with GA ≤30 weeks and BW <1501 g and blood transfused <6 weeks and/or 3-week PWG <100 g in the type 1 ROP group. Conclusion. The JED-ROP algorithm can reduce the number of infants requiring ROP screening by 35.7% without missing type 1 ROP. The algorithm can be an adjunct to current national screening guidelines.
Collapse
Affiliation(s)
- Lina Raffa
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Aliaa Alamri
- Department of Pediatrics, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Amal Alosaimi
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Sara Alessa
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Suzan AlHarbi
- Department of Ophthalmology, Jeddah Eye Hospital, Jeddah, Saudi Arabia
| | - Sara AlNowaiser
- Faculty of Medicine and Health Sciences, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Huda Ahmedhussein
- Department of Ophthalmology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hashem Almarzouki
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Western Region, Jeddah, Saudi Arabia
- Department of Ophthalmology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mansour Al Qurashi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Western Region, Jeddah, Saudi Arabia
- Department of Pediatrics, Neonatology Division, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Western Region, Jeddah, Saudi Arabia
| |
Collapse
|
15
|
Bremner A, Chan LY, Jones C, Shah SP. Comparison of Weight-Gain-Based Prediction Models for Retinopathy of Prematurity in an Australian Population. J Ophthalmol 2023; 2023:8406287. [PMID: 37670799 PMCID: PMC10477029 DOI: 10.1155/2023/8406287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 06/26/2023] [Accepted: 07/21/2023] [Indexed: 09/07/2023] Open
Abstract
Purpose Four weight-gain-based algorithms are compared for the prediction of type 1 ROP in an Australian cohort: the weight, insulin-like growth factor, neonatal retinopathy of prematurity (WINROP) algorithm, the Children's Hospital of Philadelphia Retinopathy of Prematurity (CHOPROP), the Colorado Retinopathy of Prematurity (CO-ROP) algorithm, and the postnatal growth, retinopathy of prematurity (G-ROP) algorithm. Methods A four-year retrospective cohort analysis of infants screened for ROP in a tertiary neonatal intensive care unit in Brisbane, Australia. The main outcome measures were sensitivities, specificities, and positive and negative predictive values. Results 531 infants were included (mean gestational age 28 + 3). 24 infants (4.5%) developed type 1 ROP. The sensitivities, specificities, and negative predictive values, respectively, for type 1 ROP (95% confidence intervals) were for WINROP 83.3% (61.1-93.3%), 52.3% (47.8-56.7%), and 98.4% (96.1-99.4%); for CHOPROP 100% (86.2-100%), 46.0% (41.7-50,3%), and 100% (98.4-100%); for CO-ROP 100% (86.2-100%), 32.0% (28.0%-36.1%), and 100% (98.3-100%); and for G-ROP 100% (86.2-100%), 28.2% (24.5-32.3%), and 100% (97.4-100%). Of the five infants with persistent nontype 1 ROP that underwent treatment, only CO-ROP was able to successfully identify all. Conclusions CHOPROP, CO-ROP, and G-ROP performed well in this Australian population. CHOPROP, CO-ROP, and G-ROP would reduce the number of infants requiring examinations by 43.9%, 30.5%, and 26.9%, respectively, compared to current ROP screening guidelines. Weight-gain-based algorithms would be a useful adjunct to the current ROP screening.
Collapse
Affiliation(s)
- Alexander Bremner
- University of Sydney, Ophthalmology, Camperdown 2006, NSW, Australia
| | - Li Yen Chan
- Mater Mother's Hospital Brisbane, Raymond Tce, South Brisbane 4101, QLD, Australia
| | - Courtney Jones
- Mater Mother's Hospital Brisbane, Raymond Tce, South Brisbane 4101, QLD, Australia
| | - Shaheen P. Shah
- Mater Mother's Hospital Brisbane, Raymond Tce, South Brisbane 4101, QLD, Australia
- University of Queensland, Ophthalmology, Woolloongabba 4102, QLD, Australia
| |
Collapse
|
16
|
Pivodic A, Holmström G, Smith LEH, Hård AL, Löfqvist C, Al-Hawasi A, Larsson E, Lundgren P, Gränse L, Tornqvist K, Wallin A, Johansson H, Albertsson-Wikland K, Nilsson S, Hellström A. Prognostic Value of Parenteral Nutrition Duration on Risk of Retinopathy of Prematurity: Development and Validation of the Revised DIGIROP Clinical Decision Support Tool. JAMA Ophthalmol 2023; 141:716-724. [PMID: 37382945 PMCID: PMC10311427 DOI: 10.1001/jamaophthalmol.2023.2336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/20/2023] [Indexed: 06/30/2023]
Abstract
Importance The prognostic impact of parenteral nutrition duration (PND) on retinopathy of prematurity (ROP) is not well studied. Safe prediction models can help optimize ROP screening by effectively discriminating high-risk from low-risk infants. Objective To evaluate the prognostic value of PND on ROP; to update and validate the Digital ROP (DIGIROP) 2.0 birth into prescreen and screen prediction models to include all ROP-screened infants regardless of gestational age (GA) and incorporate PND; and to compare the DIGIROP model with the Weight, IGF-1, Neonatal, and ROP (WINROP) and Postnatal Growth and ROP (G-ROP) models. Design, Setting, and Participants This retrospective study included 11 139 prematurely born infants from 2007 to 2020 from the Swedish National Registry for ROP. Extended Poisson and logistic models were applied. Data were analyzed from August 2022 to February 2023. Main Outcomes and Measures Any ROP and ROP requiring treatment were studied in relation to PND. ROP treatment was the outcome in DIGIROP models. Sensitivity, specificity, area under the receiver operating characteristic curve, and adjusted OR (aOR) with 95% CI were the main measures. Internal and external validations were performed. Results Of 11 139 screened infants, 5071 (45.5%) were girls, and the mean (SD) gestational age was 28.5 (2.4) weeks. ROP developed in 3179 infants (29%), treatment was given in 599 (5%), 7228 (65%) had PND less than 14 days, 2308 (21%) had PND for 14 days or more, and 1603 (14%) had unknown PND. PND was significantly correlated with ROP severity (Spearman r = 0.45; P < .001). Infants with 14 days or more of PND vs less than 14 days had faster progression from any ROP to ROP treatment (adjusted mean difference, -0.9 weeks; 95% CI, -1.5 to -0.3; P = .004). Infants with PND for 14 days or more vs less than 14 days had higher odds of any ROP (aOR, 1.84; 95% CI, 1.62-2.10; P < .001) and of severe ROP requiring treatment (aOR, 2.20; 95% CI, 1.73-2.80; P < .001). Among all 11 139 infants, the DIGIROP 2.0 models had 100% sensitivity (95% CI, 99.4-100). The specificity was 46.6% (95% CI, 45.6-47.5) for the prescreen model and 76.9% (95% CI, 76.1-77.7) for the screen model. G-ROP as well as the DIGIROP 2.0 prescreen and screen models showed 100% sensitivity on a validation subset (G-ROP: sensitivity, 100%; 95% CI, 93-100; DIGIROP prescreen: sensitivity, 100%; 95% CI, 93-100; DIGIROP screen: sensitivity, 100%; 95% CI, 93-100), whereas WINROP showed 89% sensitivity (95% CI, 77-96). Specificity for each prediction model was 29% (95% CI, 22-36) for G-ROP, 38% (95% CI, 32-46) for DIGIROP prescreen, 53% (95% CI, 46-60) for DIGIROP screen at 10 weeks, and 46% (95% CI, 39-53) for WINROP. Conclusion and Relevance Based on more than 11 000 ROP-screened infants born in Sweden, PND of 14 days or more corresponded to a significantly higher risk of having any ROP and receiving ROP treatment. These findings provide evidence to support consideration of using the updated DIGIROP 2.0 models instead of the WINROP or G-ROP models in the management of ROP.
Collapse
Affiliation(s)
- Aldina Pivodic
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gerd Holmström
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Lois E. H. Smith
- Department of Ophthalmology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anna-Lena Hård
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Chatarina Löfqvist
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Abbas Al-Hawasi
- Division of Ophthalmology, Department of Biomedical and Clinical Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - Eva Larsson
- Department of Surgical Sciences/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Pia Lundgren
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lotta Gränse
- Department of Clinical Sciences, Ophthalmology, Skane University Hospital, Lund University, Lund, Sweden
| | - Kristina Tornqvist
- Department of Clinical Sciences, Ophthalmology, Skane University Hospital, Lund University, Lund, Sweden
| | | | - Helena Johansson
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Staffan Nilsson
- Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Hellström
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
17
|
Binenbaum G. Retinopathy of Prematurity Screening-Asking the Proper Question. JAMA Ophthalmol 2023; 141:725-726. [PMID: 37382927 DOI: 10.1001/jamaophthalmol.2023.2782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Affiliation(s)
- Gil Binenbaum
- Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| |
Collapse
|
18
|
Trinavarat A, Najmuangchan N, Ngerncham S, Piampradad S, Nunthanid P, Tatritorn D, Amnartpanich T, Limkongngam N, Praikanarat T, Arjkongharn N, Udompunthurak S, Atchaneeyasakul LO. Validation of the postnatal growth and retinopathy of prematurity (G-ROP) screening criteria in a Thai cohort. Jpn J Ophthalmol 2023:10.1007/s10384-023-01003-9. [PMID: 37341847 DOI: 10.1007/s10384-023-01003-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/26/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE To validate Postnatal Growth and Retinopathy of Prematurity (G-ROP) criteria for Thai infants. STUDY DESIGN A retrospective review of infants receiving ROP screening during 2009-2020. METHODS Baseline characteristics, clinical progression and final ROP outcomes were collected. G-ROP was applied to infants who met at least one of the following 6 criteria: birth weight (BW) below 1051 g, gestational age (GA) under 28 weeks, weight gain (WG) less than 120 g during postnatal day 10-19, WG less than 180 g during day 20-29, WG less than 170 g during day 30-39 and hydrocephalus. RESULTS A total of 684 infants (boys, 53.4%) were included. Median (IQR) BW was 1200 (960-1470) grams and median GA was 30 (28-32) weeks. Prevalence of ROP was 26.6%, with 28 (4.1%) having type 1, 19 (2.8%) type 2 and, 135 (19.7%) having other ROP. Treatment was performed in 26 infants (3.8%). Sensitivity of G-ROP to include type 1, 2 or treatment-requiring ROP cases was 100% with 36.9% specificity, excluding 235 (34.4%) cases of unnecessary screening. To adjust for our setting of initial eye examination at 4 weeks' postnatal date, the last 2 criteria of G-ROP were replaced by the occurrence of grade 3 or 4 intraventricular hemorrhage (IVH). This modified G-ROP criteria yielded 100% sensitivity, 42.5% specificity and excluded 271 (39.6%) cases of unnecessary screening. CONCLUSION G-ROP criteria can be applied to our hospital setting. Occurrence of IVH grade 3 or 4 was proposed as an alternative in modified G-ROP criteria.
Collapse
Affiliation(s)
- Adisak Trinavarat
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Natthapicha Najmuangchan
- Division of Neonatology, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sopapan Ngerncham
- Division of Neonatology, Department of Paediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Saranporn Piampradad
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Poonyawee Nunthanid
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Dussadee Tatritorn
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Thipsukon Amnartpanich
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Nutchanok Limkongngam
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Thanyaporn Praikanarat
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Niracha Arjkongharn
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Suthipol Udompunthurak
- Division of Clinical Epidemiology, Department of Health Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - La-Ongsri Atchaneeyasakul
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
| |
Collapse
|
19
|
Legocki AT, Lee AY, Ding L, Moshiri Y, Zepeda EM, Gillette TB, Grant LE, Shariff A, Touch P, Lee CS, Tarczy-Hornoch K, Cabrera MT. Multivariate Models to Diagnose Early Referral-Warranted Retinopathy of Prematurity With Handheld Optical Coherence Tomography. Transl Vis Sci Technol 2023; 12:26. [PMID: 37223917 PMCID: PMC10214879 DOI: 10.1167/tvst.12.5.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/23/2023] [Indexed: 05/25/2023] Open
Abstract
Purpose The purpose of this study was to create multivariate models predicting early referral-warranted retinopathy of prematurity (ROP) using non-contact handheld spectral-domain optical coherence tomography (OCT) and demographic data. Methods Between July 2015 and February 2018, infants ≤1500 grams birth weight or ≤30 weeks gestational age from 2 academic neonatal intensive care units were eligible for this study. Infants were excluded if they were too unstable to participate in ophthalmologic examination (2), had inadequate image quality (20), or received prior ROP treatment (2). Multivariate models were created using demographic variables and imaging findings to identify early referral-warranted ROP (referral-warranted ROP and/or pre-plus disease) by routine indirect ophthalmoscopy. Results A total of 167 imaging sessions of 71 infants (45% male infants, gestational age 28.2+/-2.8 weeks, and birth weight 995.6+/-292.0 grams) were included. Twelve of 71 infants (17%) developed early referral-warranted ROP. The area under the receiver operating characteristic curve (AUC) was 0.94 for the generalized linear mixed model (sensitivity = 95.5% and specificity = 80.7%) and 0.83 for the machine learning model (sensitivity = 91.7% and specificity = 77.8%). The strongest variables in both models were birth weight, image-based Vitreous Opacity Ratio (an estimate of opacity density), vessel elevation, and hyporeflective vessels. A model using only birth weight and gestational age yielded an AUC of 0.68 (sensitivity = 77.3% and specificity = 63.4%), and a model using only imaging biomarkers yielded 0.88 (sensitivity = 81.8% and specificity = 84.8%). Conclusions A generalized linear mixed model containing handheld OCT biomarkers can identify early referral-warranted ROP. Machine learning produced a less optimal model. Translational Relevance With further validation, this work may lead to a better-tolerated ROP screening tool.
Collapse
Affiliation(s)
- Alex T. Legocki
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Aaron Y. Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- The Roger and Angie Karalis Johnson Retina Center, Seattle, WA, USA
| | - Leona Ding
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Yasman Moshiri
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA
| | - Emily M. Zepeda
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma, Oklahoma City, OK, USA
| | - Thomas B. Gillette
- Department of Ophthalmology, University of South Florida Eye Institute, Tampa, FL, USA
| | - Laura E. Grant
- Department of Ophthalmology, Millman-Derr Center for Eye Care, Rochester Hills, MI, USA
| | - Ayesha Shariff
- Department of Ophthalmology, New Mexico Veterans Affairs Medical Center, University of New Mexico, Albuquerque, NM, USA
| | - Phanith Touch
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Cecilia S. Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- The Roger and Angie Karalis Johnson Retina Center, Seattle, WA, USA
| | - Kristina Tarczy-Hornoch
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Division of Ophthalmology, Seattle Children's Hospital, Seattle, WA, USA
| | - Michelle T. Cabrera
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Division of Ophthalmology, Seattle Children's Hospital, Seattle, WA, USA
| |
Collapse
|
20
|
Prasad M, Ingolfsland EC, Christiansen SP. Modifiable Risk Factors and Preventative Strategies for Severe Retinopathy of Prematurity. Life (Basel) 2023; 13:life13051075. [PMID: 37240719 DOI: 10.3390/life13051075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 05/28/2023] Open
Abstract
Severe ROP is characterized by the development of retinal fibrovascular proliferation that may progress to retinal detachment. The purpose of this report is to review five of the most common and well-studied perinatal and neonatal modifiable risk factors for the development of severe ROP. Hyperoxemia, hypoxia, and associated prolonged respiratory support are linked to the development of severe ROP. While there is a well-established association between clinical maternal chorioamnionitis and severe ROP, there is greater variability between histologic chorioamnionitis and severe ROP. Neonatal sepsis, including both bacterial and fungal subtypes, are independent predictors of severe ROP in preterm infants. Although there is limited evidence related to platelet transfusions, the risk of severe ROP increases with the number and volume of red blood cell transfusions. Poor postnatal weight gain within the first six weeks of life is also strongly tied to the development of severe ROP. We also discuss preventative strategies that may reduce the risk of severe ROP. Limited evidence-based studies exist regarding the protective effects of caffeine, human milk, and vitamins A and E.
Collapse
Affiliation(s)
- Minali Prasad
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Ellen C Ingolfsland
- Department of Pediatrics, Division of Neonatology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Stephen P Christiansen
- Departments of Ophthalmology and Pediatrics, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA 02118, USA
| |
Collapse
|
21
|
Čolić A, Vukojević N, Anić Jurica S. ASSESSMENT OF NEONATAL CARE STANDARD BY THE PREDICTIVE MODEL FOR RETINOPATHY OF PREMATURITY BASED ON WEIGHT GAIN. Acta Clin Croat 2023; 62:175-183. [PMID: 38304365 PMCID: PMC10829965 DOI: 10.20471/acc.2023.62.01.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/26/2023] [Indexed: 02/03/2024] Open
Abstract
Care of extremely premature infants is in constant need for evaluation and progress. WINROP, a predictive model based on weight gain, has been developed to reduce the number of stressful examinations for retinopathy for prematurity. Validation studies of WINROP emphasize the difference of applicability in neonatal units of various practice. The aim of the study was to assess the standard of neonatal care by WINROP. Data on extremely premature infants were collected from medical records and entered in WINROP. High- and low-risk WINROP distribution and retinopathy of prematurity outcomes were analyzed. Fifty-four infants, gestational age ≤28 weeks, were included in the study after exclusion of weight related comorbidities. High risk was noted in 74% (n=40) of infants with 24% (n=13) developing retinopathy of prematurity requiring treatment. In low alarm group, there were 3 cases with severe disease. In conclusion, WINROP is not just a provider of predictive information on the severity of retinopathy of prematurity. High-risk alarm indicates the need of adjustment of nutritional strategies. Infants without pathological growth morbidities who develop severe retinopathy of prematurity in low-risk group point to other risk factors for retinopathy of prematurity to be evaluated and changed in future practice.
Collapse
Affiliation(s)
- Ana Čolić
- Division of Neonatology, Department of Gynecology and Obstetrics, Zagreb University Hospital Center, Zagreb, Croatia
| | - Nenad Vukojević
- School of Medicine, University of Zagreb, Department of Ophthalmology, Zagreb University Hospital Center, Zagreb, Croatia
| | - Sonja Anić Jurica
- Division of Neonatology, Department of Gynecology and Obstetrics, Zagreb University Hospital Center, Zagreb, Croatia
| |
Collapse
|
22
|
Raffa LH, Bugshan N, Aljuhani R, Alghoribi R, Alharbi A, Aljohani W. Retrospective validation of the postnatal Growth and Retinopathy of Prematurity (G-ROP) criteria in a developing country. Niger J Clin Pract 2023; 26:217-222. [PMID: 36876611 DOI: 10.4103/njcp.njcp_523_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Background The characteristics of premature infants vary from country to country rendering it challenging to apply retinopathy of prematurity (ROP) screening algorithm globally. The screening criteria for postnatal growth and ROP (G-ROP) for preterm infants are known to be beneficial, but it is not clear whether these criteria can be used universally. Aim The aim of this study is to validate the accuracy of the G-ROP criteria in screening preterm infants in Saudi Arabia. Subjects and Methods This single-center retrospective study included 300 premature infants (mean gestational age [GA], 28.72 ± 2.2 weeks; range, 21-36 weeks) at a referral center who were screened for ROP between 2015 and 2021. The inclusion criteria were the availability of data on ROP outcome and body weight up until day 40 after birth. The G-ROP 1 and G-ROP 2 models were examined for their ability and accuracy in identifying infants with any stage ROP and treatable ROP. Results The G-ROP 1 and G-ROP 2 models identified 233 and 255 infants for screening, respectively. The sensitivity of G-ROP 1 and G-ROP 2 for detecting treated ROP was 96.7% and 100%, respectively, and the specificity for detecting treatable ROP was 24.4% and 16.7%, respectively. Incorporation of the G-ROP 2 model, which did not miss any infant with type 1 ROP, would have reduced the number of screened infants by 15%. Conclusion G-ROP 2 was more sensitive than G-ROP 1 for identifying infants who required treatment and could potentially reduce the burden of ROP screening.
Collapse
Affiliation(s)
- L H Raffa
- Department of Ophthalmology, King Abdulaziz University Hospital; Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - N Bugshan
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - R Aljuhani
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - R Alghoribi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - A Alharbi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - W Aljohani
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
23
|
Characteristics of babies with unstable clinical course screened for retinopathy of prematurity. J AAPOS 2023; 27:37-39. [PMID: 36462723 DOI: 10.1016/j.jaapos.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 12/02/2022]
Abstract
The medical records of 2,457 infants screened and staged for retinopathy of prematurity (ROP) at the University of Colorado Hospital and Children's Hospital Colorado between 2006 and 2021 were reviewed to identify those with "unstable clinical course," that is, babies who did not meet the published birthweight (BW) or gestational age (GA) screening criteria but for whom an ROP examination was requested by the treating neonatologist. A total of 146 infants (5.9%) with unstable clinical course were identified and found to be similar to infants meeting the BW/GA criteria for ROP screening in terms of sex, race/ethnicity, and singleton/multiple birth. Four of the unstable clinical course babies (2.7%) developed mild ROP; none developed type 1 or type 2 ROP. Rates of ROP were higher among babies meeting the BW/GA criteria, in which 6.9% developed type 1, 6.2% type 2, and 22.2% mild ROP (P < 0.0001). Overall, infants with unstable clinical course and screened for ROP did not develop treatment-requiring ROP.
Collapse
|
24
|
Lu Y, Lv Z, Cen J, Tao J, Zhang Y, Zhang Y, Mao J, Chen Y, Wu M, Chen S, Shen L. Retrospective validation of G-ROP, CO-ROP, Alex-ROP, and ROPscore predictive algorithms in two Chinese medical centers. Front Pediatr 2023; 11:1079290. [PMID: 36911038 PMCID: PMC9992401 DOI: 10.3389/fped.2023.1079290] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/25/2023] [Indexed: 02/24/2023] Open
Abstract
Purpose To evaluate the sensitivity and specificity of four predictive algorithms (G-ROP, CO-ROP, Alex-ROP, and ROPscore) for retinopathy of prematurity and compare their performances in the Chinese population. Methods A retrospective study was conducted at two medical centers in China of infants born at Women's Hospital School of Medicine Zhejiang University and Yiwu Maternal and Child Health Hospital. A total of 1,634 infants who met the criteria and who were GA < 32 weeks or BW < 2,000 g according to Chinese guidelines for ROP screening were included. The ROP group was further grouped into severe ROP and mild ROP. The sensitivity and specificity of G-ROP, two simplified G-ROPs, CO-ROP, Alex-ROP, and ROPscore were analyzed. Results Severe ROP and any ROP were identified in 25 and 399 of 1,634 infants, respectively. According to the criteria of different models, 844, 1,122, 1,122, and 587 infants were eligible in the G-ROP, CO-ROP, Alex-ROP, and ROPscore, respectively. G-ROP had 96.0% sensitivity and 35.0% specificity for severe ROP. For two simplified G-ROPs (180 g and 200 g models), similar sensitivity was showed with original G-ROP and they had specificity of 21.8% and 14.0%, respectively. The sensitivity and specificity of Co-ROP were 96% and 64.3% for severe ROP, while Alex-ROP only had sensitivity of 56.0% and specificity of 61.4% for severe ROP. ROPscore had a sensitivity of 91.3% and a specificity of 62.4% for severe ROP. In 546 infants who met all 4 models' inclusion criteria and included 23 infants with severe ROP, the validation outcomes showed the sensitivity of G-ROP, ROPscore, CO-ROP, and Alex-ROP for severe ROP was 95.6%, 91.3%, 100%, and 56.0%, and their specificity was 38.0%, 60.8%, 39.9%, and 52.9%, respectively. Conclusion G-ROP, ROPscore, and CO-ROP had high sensitivity for severe ROP in the Chinese population, but both the sensitivity and specificity of Alex-ROP were low. CO-ROP (not high-grade CO-ROP) provided the best performance for severe ROP in a fair comparison. For further application, ROP screening models need to be adjusted by local populations.
Collapse
Affiliation(s)
- Yang Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,Department of Ophthalmology, Lishui People's Hospital, Lishui, China
| | - Zhe Lv
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jiner Cen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,Department of Ophthalmology, Jiaxing Second People's Hospital, Jiaxing, China
| | - Jiwei Tao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yun Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yifan Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Jianbo Mao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Yiqi Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Mingyuan Wu
- Department of Neonatology and Pediatrics, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China
| | - Shujun Chen
- Department of Neonatology and Pediatrics, Yiwu Maternity and Children Hospital, Yiwu, China
| | - Lijun Shen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, China
| |
Collapse
|
25
|
Okbay Gunes A, Topcuoglu S, Celik G, Kizilay O, Akyurekli MAR, Karadag N, Ozalkaya E, Karatekin G. G-ROP criteria for predicting retinopathy of prematurity among neonates with different birth weight percentiles. J AAPOS 2022; 26:309.e1-309.e5. [PMID: 36283600 DOI: 10.1016/j.jaapos.2022.08.527] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/20/2022] [Accepted: 08/09/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study showed that adding postnatal weight gain to birth weight and gestational age detected 100% of cases with type 1 retinopathy of prematurity (ROP) while reducing the ROP examinations by 30%. The purpose of this study was to investigate whether being small for gestational age (SGA) affects the sensitivity and specificity of the G-ROP model. METHODS We applied the G-ROP criteria for premature infants. The infants were classified as three subgroups: SGA, appropriate for gestational age (AGA), and large for gestational age (LGA). The performance of G-ROP criteria was assessed for each group for ROP. RESULTS There were 41 (10.5%) SGA, 312 (80%) AGA, and 37 (9.5%) LGA neonates. Twenty-six (6.7%) neonates were treated for ROP, and the G-ROP model identified all of them. The sensitivity of the model for treatment-requiring ROP (TR-ROP) was found to be 100% in the whole patient group and for each subgroup. The specificity for TR-ROP was 46.4% for the whole group, 50% for SGA, 44% for AGA, and 63.6% for LGA. By applying the G-ROP model, the number of ROP examinations could be reduced by 25% for the whole group, 27% for SGA, 24% for AGA, and 31% for LGA, without missing TR-ROP. CONCLUSIONS The sensitivity and specificity of the G-ROP model for TR-ROP in SGA infants were similar to the whole group. The model did not miss any cases of TR-ROP.
Collapse
Affiliation(s)
- Asli Okbay Gunes
- Department of Pediatrics, Division of Neonatology, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey.
| | - Sevilay Topcuoglu
- Department of Pediatrics, Division of Neonatology, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Gokhan Celik
- Department of Ophthalmology, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Osman Kizilay
- Department of Ophthalmology, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Muhammed Ali Recai Akyurekli
- Department of Pediatrics, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Nilgun Karadag
- Department of Pediatrics, Division of Neonatology, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Elif Ozalkaya
- Department of Pediatrics, Division of Neonatology, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| | - Guner Karatekin
- Department of Pediatrics, Division of Neonatology, Health Sciences University, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
26
|
Fadakar K, Abbas H, Soltani Shahgoli S, Tuli S, Farahani A, Imani Fooladi M, Taslimi Taleghani N, Esfandiarifard S, Roohipourmoallai R, Davoudi S, Chen J, Khoshnood Shariati M, Karkhaneh R, Ebrahimiadib N. Validation of the Postnatal Growth and Retinopathy of Prematurity (GROP) screening criteria. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2022; 11:77-84. [PMID: 37641787 PMCID: PMC10445302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/07/2022] [Indexed: 08/31/2023]
Abstract
Background Retinopathy of prematurity (ROP) is a leading cause of irreversible blindness in infants. The Postnatal Growth and ROP (G-ROP) study proposed new screening criteria for ROP. This study aimed to validate the G-ROP screening criteria in a group of Iranian premature infants who were treated in the neonatal intensive care unit (NICU) for at least 40 days. Methods In this retrospective study, we extracted the data pertaining to infants admitted to the NICU from January 2020 to December 2021. We screened all the included infants for ROP based on the Iranian national screening criteria. We applied the G-ROP criteria to our study population, and if no criterion was met, the infant was exempted from ROP screening. We determined the sensitivity and specificity of the G-ROP guidelines for ROP detection, along with its capacity for predicting the requirement for ROP treatment. Moreover, we compared the G-ROP guidelines with the Iranian and North American guidelines for ROP screening. Results A total of 166 premature infants with complete datasets were included: 130 had ROP, of whom 61 were treated. There were 109 female infants (65.7%). The mean (standard deviation [SD]) birth weight and gestational age were 1080 (256) g and 28.28 (1.97) weeks, respectively. Applying the G-ROP criteria, 127 of 130 infants with ROP were identified (sensitivity, 97.69%; 95% confidence interval [CI], 95.11% - 100%), and of 36 infants without ROP, three were correctly excluded (specificity, 8.33%; 95% CI, 0% - 17.36%). The G-ROP criteria did not fail to identify infants who required treatment for ROP (sensitivity, 100%; 95% CI, 98.29 - 100) and had a specificity of 8.69% (95% CI, 2.04% - 15.34%). Although the Iranian and North American criteria had 100% sensitivity for infants with any stage of ROP, they could not detect infants without ROP (0% specificity). Conclusions The G-ROP screening criteria had a sensitivity of 100% in identifying infants requiring treatment for ROP in our high-risk group; however, specificity was not sufficiently high. Further studies with larger numbers of referred infants could confirm a decrease in the burden of retinal examinations using these criteria.
Collapse
Affiliation(s)
- Kaveh Fadakar
- Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Haider Abbas
- Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sonal Tuli
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Afsar Farahani
- Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Naeeme Taslimi Taleghani
- Clinical Research Development Center, Mahdiyeh Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ramak Roohipourmoallai
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Samaneh Davoudi
- Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA
| | - Jinghua Chen
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Maryam Khoshnood Shariati
- Clinical Research Development Center, Mahdiyeh Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Karkhaneh
- Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Ebrahimiadib
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL, USA
| |
Collapse
|
27
|
Estrada MM, Tomlinson LA, Yu Y, Ying GS, Binenbaum G. Daily Oxygen Supplementation and Risk of Retinopathy of Prematurity. Ophthalmic Epidemiol 2022; 30:317-325. [PMID: 36093765 DOI: 10.1080/09286586.2022.2111687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE Excessive oxygen supplementation increases risk of retinopathy of prematurity (ROP). While numerous oxygen parameters could be considered when predicting ROP (saturation targets, actual saturation, fraction of inspired oxygen, etc.), complicated measures are impractical as screening criteria. We sought to develop a simple, clinically useful measure of daily oxygen supplementation during ages 0-28 days to improve prediction of ROP. METHODS Secondary analysis of two Postnatal Growth and ROP (G-ROP) Study cohorts (G-ROP-1 and G-ROP-2) at 45 hospitals. Infants with a known ROP outcome and complete oxygen data were included. Associations between severe ROP and days on supplemental oxygen (FiO2 > 21%), during ages 0-28 days (DSO28) were assessed, controlling for birth weight (BW) and gestational age (GA). New screening criteria incorporating DSO were developed and compared to current guidelines. RESULTS Among 8,949 studied infants, 459 (5.1%) developed type 1 ROP. DSO28 was associated with severe ROP (adjusted-OR 1.05 per day supplemental oxygen, 95%CI 1.03-1.07, p < .0001). The following criteria had 100% sensitivity for type 1 ROP and higher specificity than current guidelines: new BW/GA criteria with DSO (BW<901 g, GA<26 weeks, or DSO >3), 23.4% fewer infants examined; modified G-ROP criteria including DSO, 29.0% fewer infants; original G-ROP criteria, 31.8% fewer infants. CONCLUSION In high-level neonatal-care settings, incorporating DSO (a simple measure of oxygen supplementation) into screening criteria improves sensitivity and specificity for type 1 ROP over current BW-GA criteria, but does not perform as well as the validated G-ROP criteria.
Collapse
Affiliation(s)
- Marcela M. Estrada
- Department of Ophthalmology, University of California, Sacramento, California, USA
| | | | - Yinxi Yu
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gui-Shuang Ying
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gil Binenbaum
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Ophthalmology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| |
Collapse
|
28
|
Sabri K, Ells AL, Lee EY, Dutta S, Vinekar A. Retinopathy of Prematurity: A Global Perspective and Recent Developments. Pediatrics 2022; 150:188757. [PMID: 35948728 DOI: 10.1542/peds.2021-053924] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/24/2022] Open
Abstract
Retinopathy of prematurity (ROP) is a significant cause of potentially preventable blindness in preterm infants worldwide. It is a disease caused by abnormal retinal vascularization that, if not detected and treated in a timely manner, can lead to retinal detachment and severe long term vision impairment. Neonatologists and pediatricians have an important role in the prevention, detection, and management of ROP. Geographic differences in the epidemiology of ROP have been seen globally over the last several decades because of regional differences in neonatal care. Our understanding of the pathophysiology, risk factors, prevention, screening, diagnosis, and treatment of ROP have also evolved over the years. New technological advances are now allowing for the incorporation of telemedicine and artificial intelligence in the management of ROP. In this comprehensive update, we provide a comprehensive review of pathophysiology, classification, diagnosis, global screening, and treatment of ROP. Key historical milestones as well as touching upon the very recent updates to the ROP classification system and technological advances in the field of artificial intelligence and ROP will also be discussed.
Collapse
Affiliation(s)
- Kourosh Sabri
- Department of Ophthalmology, McMaster University, Ontario, Canada
| | - Anna L Ells
- Calgary Retina Consultants, University of Calgary, Calgary, Alberta, Canada
| | - Elizabeth Y Lee
- Department of Ophthalmology, McMaster University, Ontario, Canada
| | - Sourabh Dutta
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anand Vinekar
- Department of Pediatric Retina, Narayana Nethralaya Eye Institute, Bangalore, India
| |
Collapse
|
29
|
Zhang DL, Yoon HH, deRegnier RAO, Arzu J, Rahmani S. Postnatal Growth Trajectories and Neurodevelopmental Outcomes Following Bevacizumab Treatment for Retinopathy of Prematurity. Clin Ophthalmol 2022; 16:2713-2722. [PMID: 36035240 PMCID: PMC9401100 DOI: 10.2147/opth.s378520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the postnatal growth and neurodevelopment of infants with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB). Patients and Methods This was a retrospective comparative study. A total of 262 infants were divided among three study groups: 22 treated with intravitreal bevacizumab, 55 treated with laser, and 185 with ROP that resolved without treatment. Infants with nonviable course or hydrocephalus, a source of non-physiologic weight gain, were excluded. Neurodevelopment was assessed with Bayley III scores at 17–28 months if available and presence of hearing loss or cerebral palsy. Weekly weight, height, and head circumference from birth through 50 weeks postmenstrual age (PMA) were modeled to determine differences in growth trajectories following treatment. Results Comparison of postnatal growth curves from the time of treatment to 50 weeks PMA showed no significant differences in growth trajectories between groups after adjusting for the corresponding growth parameters at birth. Comparison of Bayley scores in patients with available data (n = 120) showed no significant differences. There was an increased risk of cerebral palsy in the IVB group after logistic regression adjusting for baseline confounders, but this did not retain statistical significance after applying the false discovery rate correction for multiple testing. Conclusion To our knowledge, this is the first large retrospective study to examine longitudinal growth in infants treated with IVB compared to controls. There were no significant differences in postnatal growth or neurodevelopmental outcomes between groups, which overall continue to support the safety of bevacizumab treatment for ROP.
Collapse
Affiliation(s)
- David L Zhang
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hawke H Yoon
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Raye-Ann O deRegnier
- Division of Neonatology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Jennifer Arzu
- Division of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Safa Rahmani
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
- Correspondence: Safa Rahmani, Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA, Tel +1 312 227-6180, Fax +1 312 227-9411, Email
| |
Collapse
|
30
|
Almeida AC, Brízido M, Teixeira S, Coelho C, Borrego LM, Correia M. Incidence and Risk Factors for Retinopathy of Prematurity in a Portuguese Cohort. J Pediatr Ophthalmol Strabismus 2022; 59:254-260. [PMID: 35192376 DOI: 10.3928/01913913-20220104-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the incidence and risk factors for retinopathy of prematurity (ROP) in two Portuguese neonatal units with a sub-analysis of infants with a gestational age (GA) of 28 weeks or older. METHODS This was a retrospective case series of all infants who underwent ROP screening from 2012 to 2020. Demographic, clinical, and laboratory data were collected. Univariate logistic regression was used to examine the risk factors for ROP followed by multivariate regression. RESULTS A total of 475 infants were included with a median GA of 30 weeks (range: 23 to 36 weeks) and a median birth weight of 1,229 grams (range: 408 to 2,620 grams). ROP was diagnosed in 113 infants (23.8%) and 29 (6.1%) were treated. In the multivariate analysis, GA and hyperglycemia were significantly associated with severe ROP (P < .001). In the subgroup analysis of infants with a GA of 28 weeks or older, bronchopulmonary dysplasia, late-onset sepsis, and hyperglycemia were linked to severe ROP. CONCLUSIONS The incidence of ROP in the cohort falls within the range of other high-income countries. Hyperglycemia overpowered all of the other risk factors. Although rare, more mature infants are also at risk for severe ROP. Infants with older GA share the same group of risk factors, but bronchopulmonary dysplasia seems to play a greater role. [J Pediatr Ophthalmol Strabismus. 2022;59(4):254-260.].
Collapse
|
31
|
Huang CW, Yeh PT, Tsao PN, Chou HC, Chen CY, Yen TA, Huang HC, Lai TT. Validation of the Postnatal Growth and Retinopathy of Prematurity Screening Criteria in a Taiwanese Cohort. Am J Ophthalmol 2022; 237:22-31. [PMID: 34780799 DOI: 10.1016/j.ajo.2021.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To validate the performance of Postnatal Growth and Retinopathy of Prematurity (G-ROP) screening criteria in a Taiwanese cohort. DESIGN Screening evaluation with retrospective data. METHOD Premature infants who underwent retinopathy of prematurity (ROP) screening between January 2015 and April 2019 at a tertiary hospital were examined. Infants with known final ROP results and complete longitudinal weight records were included. G-ROP screening criteria, both original and simplified (G-ROP 180 g), were applied as the prediction model for type 1 ROP; sensitivity and specificity were analyzed. The reduction in the number of infants requiring ROP screening and the number of funduscopic examinations were calculated. RESULT A total of 303 infants with documented ROP outcomes and complete weight gain records were examined. Of these, 103 infants developed ROP, of whom 29 developed type 1 ROP, whereas the other 200 did not develop ROP. For the detection of type 1 ROP, the sensitivity and specificity of the original G-ROP screening criteria were 96.6% and 42.3%, and 100% and 31%, for the simplified G-ROP 180 g model, respectively. The reduction in the number of infants requiring screening and funduscopic examinations was 32.6% and 33.5% for the original G-ROP criteria, and 28.1% and 23.2% for the G-ROP 180 g model, respectively. CONCLUSION Both the original G-ROP and G-ROP 180 g criteria attained high sensitivities in detecting type 1 ROP in the current Taiwanese cohort, with the G-ROP 180-g model outperforming the original one. Validation and modification may be required before applying G-ROP screening criteria to different populations.
Collapse
Affiliation(s)
- Ching-Wen Huang
- From the Department of Ophthalmology (C.-W.H., P.-T.Y., T.-T.L.), National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Ting Yeh
- From the Department of Ophthalmology (C.-W.H., P.-T.Y., T.-T.L.), National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Nien Tsao
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan; Research Center for Developmental Biology & Regenerative Medicine (P.-N.T.), National Taiwan University, Taipei, Taiwan
| | - Hung-Chieh Chou
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Yi Chen
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan
| | - Ting-An Yen
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan
| | - Hsin-Chung Huang
- Department of Pediatrics (P.-N.T., H.-C.C., C.-Y.C., T.-A.Y., H.-C.H.), National Taiwan University Hospital, Taipei, Taiwan
| | - Tso-Ting Lai
- From the Department of Ophthalmology (C.-W.H., P.-T.Y., T.-T.L.), National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine (T.-T.L.), College of Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
32
|
Chinwuba I, Hubbard GB, Rao P, Weil N, Hutchinson AK. Application of the Postnatal Growth and Retinopathy of Prematurity (G-ROP) criteria at a tertiary referral hospital. J AAPOS 2022; 26:66.e1-66.e4. [PMID: 35158048 DOI: 10.1016/j.jaapos.2021.08.309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 08/08/2021] [Accepted: 08/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Application of current retinopathy of prematurity (ROP) screening criteria results in many unnecessary examinations, because only 5%-10% of infants screened require treatment. Application of screening criteria established by the Postnatal Growth and Retinopathy of Prematurity Study could significantly reduce unnecessary examinations without sacrificing sensitivity to detect treatment-requiring ROP. We evaluated the performance of the G-ROP criteria in a population of high-risk, outborn infants. METHODS The medical records of consecutive infants screened and/or treated for ROP at Children's Health Care of Atlanta Hospitals from May 1, 2013, to September 6, 2019, were reviewed retrospectively. The sensitivity of the G-ROP birthweight and gestational age screening criteria to detect treatment-requiring ROP was calculated. RESULTS During the study period, 901 children underwent examinations for ROP; of these, 5 were excluded from the analysis because birth weight (BW) data was lacking. Of the 896 remaining patients, 120 patients were treated for ROP. Application of G-ROP birth weight and gestational age (GA) criteria alone resulted in a sensitivity of 99.2% to detect infants requiring treatment. Application of weight gain criteria was problematic, because many patients were transferred into our institutions after the specified intervals of 10-19, 20-29, and 30-39 days. CONCLUSIONS G-ROP BW and GA screening criteria were highly sensitive in detecting treatment-requiring ROP. Applying weight gain criteria in referral centers can be problematic. Intake procedures at referral centers should include documentation of weight gain during 10-19, 20-29, and 30-39 days of life.
Collapse
Affiliation(s)
- Ijeoma Chinwuba
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - G Baker Hubbard
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Prethy Rao
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Natalie Weil
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Amy K Hutchinson
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
| |
Collapse
|
33
|
Iu LPL, Yip WWK, Lok JYC, Fan MCY, Lai CHY, Ho M, Young AL. Prediction model to predict type 1 retinopathy of prematurity using gestational age and birth weight (PW-ROP). Br J Ophthalmol 2022:bjophthalmol-2021-320670. [PMID: 35177402 DOI: 10.1136/bjophthalmol-2021-320670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 02/01/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To develop a prediction model for type 1 retinopathy of prematurity (ROP) from an Asian population. METHODS This retrospective cohort study included 1043 premature infants who had ROP screening in a tertiary hospital in Hong Kong from year 2006 to 2018. The ROP prediction model was developed by multivariate logistic regression analyses on type 1 ROP. The cut-off value and the corresponding sensitivity and specificity were determined by receiver operating characteristic curve analysis. A validation group of 353 infants collected from another tertiary hospital in another region of Hong Kong from year 2014 to 2017 was used for external validation. RESULTS There were 1043 infants in the study group. The median gestational age (GA) was 30 weeks and 1 day and median birth weight (BW) was 1286 g. The prediction model required only GA and BW as parameters (prematurity-birth weight ROP (PW-ROP)). The area under curve value was 0.902. The sensitivity and specificity were 87.4% and 79.3%, respectively. Type 1 ROP developed in 0.9%, 17.4% and 50% of infants with PW-ROP scores<0, between 0 and <300, and ≥300 respectively (p<0.001). On external validation, our prediction model correctly predicted 95.8% of type 1 ROP (sensitivity=95.8%, specificity=74.8%) in the validation group. CONCLUSION The PW-ROP model is a simple model which could predict type 1 ROP with high sensitivity and specificity. Incorporating this model to ROP examination would help identify infants at risk for ROP treatment.
Collapse
Affiliation(s)
- Lawrence Pui Leung Iu
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China .,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Wilson Wai Kuen Yip
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Julie Ying Ching Lok
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Connie Hong Yee Lai
- Department of Ophthalmology, Queen Mary Hospital, Hong Kong, China.,Department of Ophthalmology, The University of Hong Kong, Hong Kong, China
| | - Mary Ho
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Alvin Lerrmann Young
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
34
|
Almeida AC, Borrego LM, Brízido M, de Figueiredo MB, Teixeira F, Coelho C, Teixeira S. DIGIROP efficacy for detecting treatment-requiring retinopathy of prematurity in a Portuguese cohort. Eye (Lond) 2022; 36:463-469. [PMID: 33712731 PMCID: PMC8807590 DOI: 10.1038/s41433-021-01455-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 01/11/2021] [Accepted: 02/03/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND/OBJECTIVES To determine the efficacy of the DIGIROP model in detecting treatment-requiring retinopathy of prematurity (TR-ROP) in a Portuguese cohort. SUBJECTS/METHODS Multicentre, retrospective cohort study of all consecutive preterm infants who underwent ROP screening from April 2012 to May 2019 in two neonatal units. Gestational age (GA), birth weight (BW) and sex were inserted in the DIGIROP platform. The optimal cut-off point to achieve 100% sensitivity was calculated. Area under the receiver operating characteristic curve (AUC) was calculated. RESULTS Of the 431 infants who underwent ROP screening, 257 were eligible for DIGIROP analysis and 174 infants were excluded for having a GA outside the range 24-30 weeks imposed by the DIGIROP algorithm. Median GA was 29 weeks (range 24-30) and BW was 1060 g (range 408-2080). Twenty-tree infants (8.9%) developed TR-ROP. The highest risk obtained for TR-ROP was 0.5404 (95% CI 0.4343-0.6616) with a median achieved risk of 0.0938 (range 0.0016-0.5404). The optimal cut-off point to achieve 100% sensitivity on TR-ROP was 0.0016. The number of infants receiving ROP examinations would have been reduced from 257 to 187 infants (-27.2%) if the model was applied. CONCLUSIONS In our cohort, of 257 infants, the optimal cut-off point to achieve 100% sensitivity for TR-ROP was 0.0016 with moderate accuracy in the AUC (0.70). The number of infants requiring screening would have decreased 27.2% if the model was applied. It is essential that algorithms continue to be tested in different populations, especially in cohorts that include both younger and older GA infants.
Collapse
Affiliation(s)
- Ana C Almeida
- Hospital Beatriz Ângelo, Loures, Portugal.
- Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.
- CHRC, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.
- LUZ Saúde, Hospital da Luz de Lisboa, Lisbon, Portugal.
| | - Luís Miguel Borrego
- CHRC, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- LUZ Saúde, Hospital da Luz de Lisboa, Lisbon, Portugal
| | | | | | - Filipa Teixeira
- Hospital Santa Maria, Centro Hospitalar de Lisboa Norte, EPE, Lisbon, Portugal
| | - Constança Coelho
- Institute of Environmental Health (ISAMB), Lisbon Medical School, University of Lisbon, Lisbon, Portugal
| | - Susana Teixeira
- LUZ Saúde, Hospital da Luz de Lisboa, Lisbon, Portugal
- Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| |
Collapse
|
35
|
Changes in institutional oxygen saturation targets are associated with an increased rate of severe retinopathy of prematurity. J AAPOS 2022; 26:18.e1-18.e6. [PMID: 35032651 DOI: 10.1016/j.jaapos.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 09/25/2021] [Accepted: 10/02/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the effect of changes in institutional peripheral oxygen saturation (SpO2) targets, made in response to recent randomized trials, on risk of developing severe retinopathy of prematurity (ROP). METHODS This study was a secondary analysis of data from 21 North American hospitals during the periods 2006-2012 and 2015-2017. Hospitals were categorized based on whether or not SpO2 targets were increased between the two study periods. Severe ROP (type 1, type 2, or zone III stage 3+) rates were compared within and between groups. Generalized mixed effect models with random intercepts were used to account for within-center clustering and to calculate odds ratios (aOR) adjusted by birth weight (BW) and gestational age (GA), using patient-level data. RESULTS A total of 8,142 infants underwent ROP examinations at 21 hospitals during the two study periods: 5,716 in 2006-2012 (mean BW, 1109 ± 369 g; GA, 28.0 ± 2.6; 11.6% severe ROP); 2,426 in 2015-2017 (mean BW, 1086 ± 347 g; GA, 28.0 ± 2.8; 12.8% severe ROP). Fourteen hospitals increased SpO2 targets, and 7 hospitals did not. Hospitals that increased targets had a 3% increase in severe ROP (from 12% to 15%; aOR = 1.25; 95% CI, 1.01-1.55; P = 0.044); hospitals without SpO2 changes had a 2% decrease (from 11% to 9%; aOR = 0.72; 95% CI, 0.52-1.00; P = 0.049). The difference in change of severe ROP between groups of hospitals was significant (P = 0.005). CONCLUSIONS Increases in institutional SpO2 targets in response to recent randomized trials were associated with increased severe ROP. Hospitals considering increasing their SpO2 targets should anticipate increases in rates of severe ROP and manage screening and treatment resources accordingly.
Collapse
|
36
|
Vinayahalingam N, McDougall J, Ahrens O, Ebneter A. Retrospective validation of the postnatal Growth and Retinopathy of Prematurity (G-ROP) criteria in a Swiss cohort. BMC Ophthalmol 2022; 22:19. [PMID: 35012498 PMCID: PMC8751318 DOI: 10.1186/s12886-021-02227-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022] Open
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.
Collapse
Affiliation(s)
- Nithursa Vinayahalingam
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jane McDougall
- Department of Neonatalogy, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olaf Ahrens
- Department of Neonatalogy, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Ebneter
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| |
Collapse
|
37
|
Bae SP, Kim EK, Yun J, Yoon YM, Shin SH, Park SY. Retinopathy of Prematurity Requiring Treatment Is Closely Related to Head Growth during Neonatal Intensive Care Unit Hospitalization in Very Low Birth Weight Infants. Neonatology 2022; 119:176-183. [PMID: 35139511 DOI: 10.1159/000519714] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Retinopathy of prematurity (ROP) is caused by prenatal sensitization and postnatal insults to the immature retina. This process can be associated with the postnatal growth of preterm infants. We investigated whether ROP requiring treatment was associated with the postnatal growth failure of very low birth weight (VLBW) infants. METHOD From a cohort of VLBW infants (birth weight <1,500 g) registered in the Korean Neonatal Network from January 2013 to December 2017, 3,133 infants with gestational age (GA) between 24 and 28 weeks were included in the study. Postnatal growth failure was defined when the change in each anthropometric z-score between birth and discharge was <10th percentile of the total population. Propensity score matching (PSM) at 1:1 was performed to match the distribution of GA and postnatal morbidities between infants with and without ROP requiring treatment. Prenatal factors and ROP were analyzed by conditional logistic regression. RESULTS Of 3,133 enrolled infants, 624 (19.9%) were diagnosed with ROP requiring treatment. After PSM, ROP requiring treatment was associated with postnatal growth failure assessed by head circumference (adjusted odds ratio [aOR] 1.91, 95% confidence interval [CI] 1.18-3.09), but not weight (aOR 1.45, 95% CI 0.97-2.17) and length (aOR 1.21, 95% CI 0.81-1.82). CONCLUSION ROP requiring treatment was associated with poor head circumference growth, not with weight and length. Our findings suggest that ROP requiring treatment and poor head growth during NICU hospitalization are fundamentally related.
Collapse
Affiliation(s)
- Seong Phil Bae
- Department of Pediatrics, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Ee-Kyung Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Jungha Yun
- Department of Pediatrics, CHA University School of Medicine, CHA Ilsan Medical Center, Goyang-si, Republic of Korea
| | - Young Mi Yoon
- Department of Pediatrics, Jeju University School of Medicine, Jeju National University Hospital, Jeju-si, Republic of Korea
| | - Seung Han Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Su Yeon Park
- Department of Data Innovation, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| |
Collapse
|
38
|
Yu Y, Tomlinson LA, Binenbaum G, Ying GS. Incidence, timing and risk factors of type 1 retinopathy of prematurity in a North American cohort. Br J Ophthalmol 2021; 105:1724-1730. [PMID: 32980817 PMCID: PMC8261529 DOI: 10.1136/bjophthalmol-2020-317467] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/25/2020] [Accepted: 09/13/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Early 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. METHODS Secondary analysis of data from the two Postnatal Growth and Retinopathy of Prematurity studies. Main outcomes are the incidence and timing of type 1 ROP. RESULTS Among 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). CONCLUSIONS Type 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.
Collapse
Affiliation(s)
- Yinxi Yu
- Center for Preventive Ophthalmology and Biostatistics, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lauren A Tomlinson
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Gil Binenbaum
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Gui-Shuang Ying
- Center for Preventive Ophthalmology and Biostatistics, Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
39
|
Tsai AS, Chou HD, Ling XC, Al-Khaled T, Valikodath N, Cole E, Yap VL, Chiang MF, Chan RVP, Wu WC. Assessment and management of retinopathy of prematurity in the era of anti-vascular endothelial growth factor (VEGF). Prog Retin Eye Res 2021; 88:101018. [PMID: 34763060 DOI: 10.1016/j.preteyeres.2021.101018] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 02/06/2023]
Abstract
The incidence of retinopathy of prematurity (ROP) continues to rise due to the improved survival of very low birth weight infants in developed countries. This epidemic is also fueled by increased survival of preterm babies with variable use of oxygen and a lack of ROP awareness and screening services in resource-limited regions. Improvements in technology and a basic understanding of the disease pathophysiology have changed the way we screen and manage ROP, educate providers and patients, and improve ROP awareness. Advancements in imaging techniques, expansion of telemedicine services, and the potential for artificial intelligence-assisted ROP screening programs have created opportunities to improve ROP care in areas with a shortage of ophthalmologists trained in ROP. To address the gap in provider knowledge regarding ROP, the Global Education Network for Retinopathy of Prematurity (GEN-ROP) created a web-based tele-education training module that can be used to educate all providers involved in ROP, including non-physician ROP screeners. Over the past 50 years, the treatment of severe ROP has evolved from limited treatment modalities to cryotherapy and laser photocoagulation. More recently, there has been growing evidence to support the use of anti-vascular endothelial growth factor (VEGF) agents for the treatment of severe ROP. However, VEGF is known to be important in organogenesis and microvascular maintenance, and given that intravitreal anti-VEGF treatment can result in systemic VEGF suppression over a period of at least 1-12 weeks, there are concerns regarding adverse effects and long-term ocular and systemic developmental consequences of anti-VEGF therapy. Future research in ophthalmology to address the growing burden of ROP should focus on cost-effective fundus imaging devices, implementation of artificial intelligence platforms, updated treatment algorithms with optimal use of anti-VEGF and careful investigation of its long-term effects, and surgical options in advanced ROP. Addressing these unmet needs will aid the global effort against the ROP epidemic and optimize our understanding and treatment of this blinding disease.
Collapse
Affiliation(s)
- Andrew Sh Tsai
- Singapore National Eye Centre, Singapore; DUKE NUS Medical School, Singapore
| | - Hung-Da Chou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Xiao Chun Ling
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Tala Al-Khaled
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA
| | - Nita Valikodath
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA
| | - Emily Cole
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA
| | - Vivien L Yap
- Division of Newborn Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Michael F Chiang
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - R V Paul Chan
- Department of Ophthalmology & Visual Sciences, University of Illinois at Chicago, Illinois Eye and Ear Infirmary, Chicago, IL, USA.
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| |
Collapse
|
40
|
Athikarisamy S, Desai S, Patole S, Rao S, Simmer K, Lam GC. The Use of Postnatal Weight Gain Algorithms to Predict Severe or Type 1 Retinopathy of Prematurity: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e2135879. [PMID: 34812847 PMCID: PMC8611486 DOI: 10.1001/jamanetworkopen.2021.35879] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
IMPORTANCE The currently recommended method for screening for retinopathy of prematurity (ROP) is binocular indirect ophthalmoscopy, which requires frequent eye examinations entailing a heavy clinical workload. Weight gain-based algorithms have the potential to minimize the need for binocular indirect ophthalmoscopy and have been evaluated in different setups with variable results to predict type 1 or severe ROP. OBJECTIVE To synthesize evidence regarding the ability of postnatal weight gain-based algorithms to predict type 1 or severe ROP. DATA SOURCES PubMed, MEDLINE, Embase, and the Cochrane Library databases were searched to identify studies published between January 2000 and August 2021. STUDY SELECTION Prospective and retrospective studies evaluating the ability of these algorithms to predict type 1 or severe ROP were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data. This meta-analysis was performed according to the Cochrane guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. MAIN OUTCOMES AND MEASURES Ability of algorithms to predict type 1 or sever ROP was measured using statistical indices (pooled sensitivity, specificity, and summary area under the receiver operating characteristic curves, as well as pooled negative likelihood ratios and positive likelihood ratios and diagnostic odds ratios). RESULTS A total of 61 studies (>37 000 infants) were included in the meta-analysis. The pooled estimates for sensitivity and specificity, respectively, were 0.89 (95% CI, 0.85-0.92) and 0.57 (95% CI, 0.51-0.63) for WINROP (Weight, IGF-1 [insulinlike growth factor 1], Neonatal, ROP), 1.00 (95% CI, 0.88-1.00) and 0.60 (95% CI, 0.15-0.93) for G-ROP (Postnatal Growth and ROP), 0.95 (95% CI, 0.71-0.99) and 0.52 (95% CI, 0.36-0.68) for CHOP ROP (Children's Hospital of Philadelphia ROP), 0.99 (95% CI, 0.73-1.00) and 0.49 (95% CI, 0.03-0.74) for ROPScore, 0.98 (95% CI, 0.94-0.99) and 0.35 (95% CI, 0.22-0.51) for CO-ROP (Colorado ROP). The original PINT (Premature Infants in Need of Transfusion) ROP study reported a sensitivity of 0.98 (95% CI, 0.91-0.99) and a specificity of 0.36 (95% CI, 0.30-0.42). The pooled negative likelihood ratios were 0.19 (95% CI, 0.13-0.27) for WINROP, 0.0 (95% CI, 0.00-0.32) for G-ROP, 0.10 (95% CI, 0.02-0.53) for CHOP ROP, 0.03 (95% CI, 0.00-0.77) for ROPScore, and 0.07 (95% CI, 0.03-0.16) for CO-ROP. The pooled positive likelihood ratios were 2.1 (95% CI, 1.8-2.4) for WINROP, 2.5 (95% CI, 0.7-9.1) for G-ROP, 2.0 (95% CI, 1.5-2.6) for CHOP ROP, 1.9 (95% CI, 1.1-3.3) for ROPScore, and 1.5 (95% CI, 1.2-1.9) for CO-ROP. CONCLUSIONS AND RELEVANCE This study suggests that weight gain-based algorithms have adequate sensitivity and negative likelihood ratios to provide reasonable certainty in ruling out type 1 ROP or severe ROP. Given the implications of missing even a single case of severe ROP, algorithms with very high sensitivity (close to 100%) and low negative likelihood ratios (close to zero) need to be chosen to safely reduce the number of unnecessary examinations in infants at lower risk of severe ROP.
Collapse
Affiliation(s)
- Sam Athikarisamy
- Neonatal Directorate, Perth Children’s Hospital and King Edward Memorial Hospital for Women, Perth, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Saumil Desai
- Neonatal Directorate, Perth Children’s Hospital and King Edward Memorial Hospital for Women, Perth, Australia
| | - Sanjay Patole
- Neonatal Directorate, Perth Children’s Hospital and King Edward Memorial Hospital for Women, Perth, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Shripada Rao
- Neonatal Directorate, Perth Children’s Hospital and King Edward Memorial Hospital for Women, Perth, Australia
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Karen Simmer
- School of Medicine, University of Western Australia, Crawley, Australia
| | - Geoffrey C. Lam
- Department of Ophthalmology, Perth Children’s Hospital, Perth, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, Australia
| |
Collapse
|
41
|
Mataftsi A, Seliniotaki AK, Tzamalis A, Ziakas N. Treatment of non-type 1 retinopathy of prematurity in the Postnatal Growth and Retinopathy of Prematurity (G-ROP) study. J AAPOS 2021; 25:319. [PMID: 34619355 DOI: 10.1016/j.jaapos.2020.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 06/28/2020] [Accepted: 07/05/2020] [Indexed: 10/20/2022]
Affiliation(s)
- Asimina Mataftsi
- IInd Department of Ophthalmology, Aristotle University of Thessaloniki, Greece
| | | | - Argyrios Tzamalis
- IInd Department of Ophthalmology, Aristotle University of Thessaloniki, Greece
| | - Nikolaos Ziakas
- IInd Department of Ophthalmology, Aristotle University of Thessaloniki, Greece
| |
Collapse
|
42
|
Pheng E, Lim ZD, Tai Li Min E, Rostenberghe HV, Shatriah I. Haemoglobin Levels in Early Life among Infants with and without Retinopathy of Prematurity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137054. [PMID: 34280989 PMCID: PMC8297072 DOI: 10.3390/ijerph18137054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022]
Abstract
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.
Collapse
Affiliation(s)
- Edwin Pheng
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (E.P.); (Z.D.L.)
- Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kota Bharu 16150, Kelantan, Malaysia;
| | - Zi Di Lim
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (E.P.); (Z.D.L.)
- Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kota Bharu 16150, Kelantan, Malaysia;
| | - Evelyn Tai Li Min
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (E.P.); (Z.D.L.)
- Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kota Bharu 16150, Kelantan, Malaysia;
- Correspondence: (E.T.L.M.); (I.S.)
| | - Hans Van Rostenberghe
- Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kota Bharu 16150, Kelantan, Malaysia;
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ismail Shatriah
- Department of Ophthalmology and Visual Science, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (E.P.); (Z.D.L.)
- Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kota Bharu 16150, Kelantan, Malaysia;
- Correspondence: (E.T.L.M.); (I.S.)
| |
Collapse
|
43
|
Ahmed ISH, Aclimandos W, Azad N, Zaheer N, Barry JS, Ambulkar H, Badeeb A, Osman IM, Rashad S, Helaly HA. The Postnatal Growth and Retinopathy of Prematurity Model: A Multi-institutional Validation Study. Ophthalmic Epidemiol 2021; 29:296-301. [PMID: 34139931 DOI: 10.1080/09286586.2021.1939885] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The G-ROP model was proposed to improve the retinopathy of prematurity (ROP) screening efficiency. It is based on gestational age, birth weight and postnatal weight gain. The current study aimed to validate the G-ROP model's ability to predict ROP in cohorts of premature infants from Egypt and the United Kingdom (UK). METHODS We retrospectively reviewed the records of preterm infants born between 1st of January and 30th of June 2018 with a known outcome for ROP screening and regular weight measurements until day 39 after birth. We applied the G-ROP model to the study group and calculated the sensitivity of the model for detecting Early Treatment of ROP (ETROP) study type 1 ROP and for any ROP and calculated the reduction of the number of infants requiring ROP screening by the model application. RESULTS We applied the G-ROP model on 605 infants (504 from Egypt and 101 from the UK). The model successfully predicted all type 1 ROP cases (100% sensitivity) in both cohorts (95% confidence interval [CI], 91.1-100% in the Egyptian cohort and 65.5-100% in the UK cohort). The model reduced the number of infants requiring screening by 14.1% in the Egyptian cohort and 21.8% in the UK cohort. CONCLUSIONS The G-ROP model was successfully validated for detecting type 1 ROP and in both cohorts from Egypt and the UK.
Collapse
Affiliation(s)
- Islam S H Ahmed
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Wagih Aclimandos
- Ophthalmology Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Nadia Azad
- Ophthalmology Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Naima Zaheer
- Ophthalmology Department, Russells Hall Hospital, Dudley Group of Hospitals, West Midlands, UK
| | - John Sebastian Barry
- Ophthalmology Department, Russells Hall Hospital, Dudley Group of Hospitals, West Midlands, UK
| | - Hemant Ambulkar
- Ophthalmology Department, King's College Hospital NHS Foundation Trust, London, UK.,Department of Neonatology, King's College Hospital NHS Foundation Trust, London, UK
| | - Adham Badeeb
- Neonatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ihab Mohamed Osman
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Shaheera Rashad
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hany Ahmed Helaly
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| |
Collapse
|
44
|
Guo Z, Ma N, Wu Y, Yuan H, Luo W, Zeng L, Jie H, Li S. The safety and feasibility of the screening for retinopathy of prematurity assisted by telemedicine network during COVID-19 pandemic in Wuhan, China. BMC Ophthalmol 2021; 21:258. [PMID: 34112134 PMCID: PMC8192130 DOI: 10.1186/s12886-021-02018-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background During the coronavirus disease 2019 (COVID-19) epidemic, due to the traffic blockade and the shortage of medical resources, more and more premature infants could not receive timely and effective ROP screening, which delayed treatment and even caused children blindness. Therefore, how to carry out ROP screening safely and effectively during the epidemic was very important and urgent. This study aimed to evaluate the safety and feasibility of ROP screening assisted by telemedicine network during COVID-19 outbreak. Methods This retrospective study was conducted at Wuhan Children’s hospital in Wuhan, China, from January to October, 2020. The measures which were performed to make the ROP screening more safe and effective were summarized and the comparison between ROP screening assisted by telemedicine network in 2020 and usual screening in 2019 were analyzed. Results A total of 267 outpatient infants completed ROP screening. The median gestational age was 32 weeks (30w to 34w) and the median birth weight was 1780 g (1460 g to 2100 g). Meanwhile, 149 (55.8%) out of 267 infants were males. During January to May in 2020, 86 screening appointments were received, among which 67 (77.9%) were from telemedicine platform online. The completing percentage of total online ROP appointments was higher than that of total face-to-face appointments (58.1% VS 22. 1%, P = 0.018). As for the number of infants screened between 2020 and 2019 from Februaryto October, 54 infants completed ROP screening in 2020, which was higher than that (51participants) in 2019 on September. Furthermore, compared with the usual screening in 2019, ROP screening assisted by telemedicine network in 2020 had smaller gestational age (32w VS 33w, p<0.001) and lower birth weight (1780 g VS 1900 g, p = 0.001). However, of the 267 infants screened, 18(6.7%) had ROP while the percentage of ROP screened in 2019 was the same (44[6.7%]). During follow-up, none of medical staffs was infected and no adverse reaction was reported. Conclusions The screening for retinopathy of prematurity assisted by telemedicine network was safe and feasible during the COVID-19 pandemic. Preventive measures before and after screening were very necessary, which could effectively avoid cross infection.
Collapse
Affiliation(s)
- Zheng Guo
- Department of Ophthalmology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Nan Ma
- Department of Ophthalmology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Yixuan Wu
- Department of Ophthalmology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Hua Yuan
- Department of Ophthalmology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Wanjun Luo
- Department of infection management, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Lingkong Zeng
- Department of neonatology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Hong Jie
- Department of Ophthalmology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Shilian Li
- Department of Ophthalmology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China.
| |
Collapse
|
45
|
Pivodic A, Johansson H, Smith LEH, Hård AL, Löfqvist C, Yoder BA, Hartnett ME, Wu C, Bründer MC, Lagrèze WA, Stahl A, Al-Hawasi A, Larsson E, Lundgren P, Gränse L, Sunnqvist B, Tornqvist K, Wallin A, Holmström G, Albertsson-Wikland K, Nilsson S, Hellström A. Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity. Br J Ophthalmol 2021; 106:1573-1580. [PMID: 33980506 DOI: 10.1136/bjophthalmol-2020-318719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/21/2021] [Accepted: 04/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Prematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights. METHODS Data, including infants born at 24-30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6-14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions. RESULTS ROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6-14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%. CONCLUSIONS DIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24-30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting.
Collapse
Affiliation(s)
- Aldina Pivodic
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helena Johansson
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.,Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Lois E H Smith
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Anna-Lena Hård
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Chatarina Löfqvist
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Learning and Leadership for Health Care Professionals, Institute of Health Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bradley A Yoder
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - M Elizabeth Hartnett
- Department of Ophthalmology, John A Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Carolyn Wu
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Wolf A Lagrèze
- Department of Ophthalmology, Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Andreas Stahl
- Department of Ophthalmology, University Medicine Greifswald, Greifswald, Germany
| | - Abbas Al-Hawasi
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Eva Larsson
- Department of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Pia Lundgren
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Ophthalmology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Lotta Gränse
- Department of Clinical Sciences, Ophthalmology, Skåne University Hospital, Lund University, Lund, Sweden
| | | | - Kristina Tornqvist
- Department of Clinical Sciences, Ophthalmology, Skåne University Hospital, Lund University, Lund, Sweden
| | | | - Gerd Holmström
- Department of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Kerstin Albertsson-Wikland
- Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Staffan Nilsson
- Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden.,Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Hellström
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
46
|
Caruggi S, Scaramuzzi M, Calevo MG, Priolo E, Sposetti L, Camicione P, Ramenghi LA, Serafino M. Validation of the postnatal growth and retinopathy of prematurity screening criteria: A retrospective Italian analysis. Eur J Ophthalmol 2021; 32:11206721211011362. [PMID: 33887976 DOI: 10.1177/11206721211011362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
Collapse
Affiliation(s)
- Samuele Caruggi
- DINOGMI Department University of Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Matteo Scaramuzzi
- Department of Neurosceince, Ophthalmology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Maria Grazia Calevo
- Epidemiology, Biostatistics Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Enrico Priolo
- Department of Neurosceince, Ophthalmology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Lorenza Sposetti
- Department of Neurosceince, Ophthalmology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Paola Camicione
- Department of Neurosceince, Ophthalmology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Luca Antonio Ramenghi
- DINOGMI Department University of Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Massimiliano Serafino
- Department of Neurosceince, Ophthalmology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| |
Collapse
|
47
|
Barry GP, Yu Y, Ying GS, Tomlinson LA, Lajoie J, Fisher M, Binenbaum G. Retinal Detachment after Treatment of Retinopathy of Prematurity with Laser versus Intravitreal Anti-Vascular Endothelial Growth Factor. Ophthalmology 2020; 128:1188-1196. [PMID: 33387554 DOI: 10.1016/j.ophtha.2020.12.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/10/2020] [Accepted: 12/28/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To compare rates of short-term retinal detachment (RD) of infants treated for type 1 retinopathy of prematurity (ROP) with intravitreal anti-vascular endothelial growth factor (VEGF) therapy with infants treated with laser therapy. The choice between these 2 treatments remains controversial. Comparative data are limited and describe re-treatment rates rather than retinal structural outcomes predictive of long-term vision. Anti-vascular endothelial growth factor acts faster than laser therapy, which may be beneficial for more aggressive ROP. DESIGN Nonrandomized, comparative cohort study. PARTICIPANTS The study included 1167 eyes of 640 infants treated for type 1 ROP. Among these, 164 eyes received anti-VEGF therapy and 1003 eyes received laser therapy. METHODS Pretreatment and posttreatment examinations and treatments were completed by ophthalmologists with expertise in ROP. The study was a secondary analysis of data from the retrospective Postnatal Growth and Retinopathy of Prematurity Study (G-ROP) 1 study (2006-2012) and the prospective G-ROP 2 study (2015-2017). MAIN OUTCOME MEASURES Rate of RD (ROP stages 4A, 4B, or 5) within 8 weeks of initial treatment, an end point predictive of poor long-term vision. The results were stratified by postmenstrual age (PMA) at treatment as occurring before versus at or after 36 weeks and 0 days, because earlier disease may be considered more aggressive. RESULTS Among 458 eyes treated before PMA 36 weeks and 0 days, the short-term RD rate was higher after laser therapy (29/368 eyes [7.9%]) than after anti-VEGF therapy (0/90 eyes [0%]; P < 0.001). Of 709 eyes treated at or after PMA 36 weeks and 0 days, short-term RD risk did not differ between groups (laser [20/635 eyes], 3.1%; anti-VEGF [1/74 eyes], 1.4%; P = 0.27). CONCLUSIONS Anti-vascular endothelial growth factor therapy results in better short-term structural outcomes than laser therapy when type 1 ROP is treated before 36 weeks' PMA. After this age, both treatments have very low rates of short-term RD. The faster action of anti-VEGF agents likely is responsible for these findings.
Collapse
Affiliation(s)
- Gerard P Barry
- Albany Medical College, Department of Ophthalmology, Albany, New York.
| | - Yinxi Yu
- Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gui-Shuang Ying
- Center for Preventive Ophthalmology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lauren A Tomlinson
- Children's Hospital of Philadelphia, Department of Ophthalmology, Philadelphia, Pennsylvania
| | - Juliann Lajoie
- Albany Medical College, Department of Ophthalmology, Albany, New York
| | - Marilyn Fisher
- Albany Medical College, Department of Pediatrics, Albany, New York
| | - Gil Binenbaum
- Children's Hospital of Philadelphia, Department of Ophthalmology, Philadelphia, Pennsylvania
| |
Collapse
|
48
|
Chaves-Samaniego MJ, García Castejón M, Chaves-Samaniego MC, Solans Perez Larraya A, Ortega Molina JM, Muñoz Hoyos A, García-Serrano JL. Risk Calculator for Retinopathy of Prematurity Requiring Treatment. Front Pediatr 2020; 8:529639. [PMID: 33042928 PMCID: PMC7530187 DOI: 10.3389/fped.2020.529639] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 08/13/2020] [Indexed: 11/13/2022] Open
Abstract
Importance: Vascular delay that occurs early in the development of retinopathy of prematurity (ROP) is a risk factor that can be compensated by ensuring a good rate of retinal vascularization to avoid ROP that requires treatment. Background: The objective of the present study was to determine the association between ROP that requires treatment and risk factors such as the extent of the temporal avascular area of the retina and the number of days of mechanical ventilation (MV). Design: Observational retrospective case-control study. Participants: Two hundred and twenty-eight premature newborns included in the screening protocol for retinopathy of prematurity. Methods: Subjects underwent retinal examination in the 4 and 6th postnatal weeks. Main Outcome Measures: The temporal avascular area was measured in disc diameters (DD), while the MV time was measured in days of treatment. Results: Patients with a longer MV time had a higher risk of treatment (R 2: 24.7, p < 0.0001; increase in risk of 8.1% for each additional day), as did those who showed greater avascular area (R 2: 24.7, p < 0.0001; increase in risk of 111% for each additional DD). An online calculator system and a table are presented for calculating the risk of ROP requiring treatment as a function of these two risk factors. Conclusions and Relevance: The temporal avascular area of the retina and MV time must be taken into account in the first examination of the newborn to predict the need for ROP treatment.
Collapse
Affiliation(s)
- Maria J. Chaves-Samaniego
- Doctoral Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
- Department of Ophthalmology, San Cecilio University Hospital, Granada, Spain
| | | | | | | | | | | | | |
Collapse
|
49
|
Wadley S, Recko M, Samson S. Validation of the postnatal growth and retinopathy of prematurity screening criteria. Proc (Bayl Univ Med Cent) 2020; 33:546-549. [PMID: 33100525 DOI: 10.1080/08998280.2020.1793709] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The objective of this study was to validate the generalizability of the Postnatal Growth and Retinopathy of Prematurity Study screening criteria in a new cohort of infants at risk for retinopathy of prematurity (ROP). This retrospective validation study conducted at a single academic medical center included 484 infants at risk for ROP born between January 14, 2014, and December 21, 2019. The primary outcomes evaluated were sensitivity for both type 1 and type 2 ROP, as defined by the Early Treatment of Retinopathy of Prematurity Study, as well as the reduction in total number of infants requiring ROP examinations. Secondary outcomes included the total number of ROP examinations avoided and the potential cost reduction of eliminating these examinations. In a cohort of 484 infants at risk for ROP, the criteria identified 40 of 40 (100%, 95% confidence interval 91.19%-100%) type 1 ROP cases and 27 of 27 (100%, 95% confidence interval 87.23%-100%) type 2 ROP cases while reducing the total number of infants screened by 35.7%. The Postnatal Growth and Retinopathy of Prematurity Study criteria were found in this study to be generalizable to a cohort of infants at a single teaching institution in central Texas. If applied during the studied interval, these criteria could have significantly reduced the number of infants undergoing ROP examinations and maintained excellent sensitivity for type 1 ROP.
Collapse
Affiliation(s)
- Sean Wadley
- Department of Ophthalmology, Baylor Scott & White Medical Center - Temple, Temple, Texas
| | - Matthew Recko
- Department of Ophthalmology, Baylor Scott & White Medical Center - Temple, Temple, Texas
| | - Shoji Samson
- Department of Pediatrics, Baylor Scott & White Medical Center - Temple, Temple, Texas
| |
Collapse
|
50
|
Evaluation of the economic impact of modified screening criteria for retinopathy of prematurity from the Postnatal Growth and ROP (G-ROP) study. J Perinatol 2020; 40:1100-1108. [PMID: 32111976 PMCID: PMC8840947 DOI: 10.1038/s41372-020-0605-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/07/2020] [Accepted: 01/31/2020] [Indexed: 01/12/2023]
Abstract
IMPORTANCE The Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study showed that the addition of postnatal weight gain to birth weight and gestational age detects similar numbers of infants with ROP, but requires examination of fewer infants. OBJECTIVE To determine the incremental cost-effectiveness of screening with G-ROP compared with conventional screening. DESIGN, SETTING AND PARTICIPANTS We built a microsimulation model of a 1-year US birth cohort <32 weeks gestation, using data from the G-ROP study. We obtained resource utilization estimates from the G-ROP dataset and from secondary sources, and test characteristics from the G-ROP cohort. RESULTS Among 78,281 infants nationally, screening with G-ROP detected ~25 additional infants with Type 1 ROP. This was accomplished with 36,233 fewer examinations, in 14,073 fewer infants, with annual cost savings of approximately US$2,931,980 through hospital discharge. CONCLUSIONS Screening with G-ROP reduced costs while increasing the detection of ROP compared with current screening guidelines.
Collapse
|