Local validation of WINROP, an online screening tool for retinopathy of prematurity

Objective@#To validate WINROP, a web-based screening tool for retinopathy of prematurity (ROP), in the detection of any-stage ROP or treatment-requiring ROP among Filipino preterm infants screened for ROP from January 2013 to April 2017.@*Methods@#Charts of preterm infants who were screened for ROP at a tertiary hospital from January 2013 to April 2017 were reviewed. Birth date, gestational age, birth weight, and weekly postnatal weight measurements were collected and entered into WINROP. The number of infants that were tagged by WINROP with alarm signals for any-stage ROP or treatment-requiring ROP were noted and compared with actual ROP screening findings. The sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) of the WINROP application in predicting any-stage ROP and treatment-requiring ROP were computed.@*Results@#Charts of 138 preterm infants were included in the study. Sixty-four (64) had a chart diagnosis of anystage ROP and 13 had treatment-requiring ROP. WINROP tagged 77 and 10 preterm infants with any-stage ROP and treatment-requiring ROP, respectively. The sensitivity and specificity rates of WINROP for detecting any-stage ROP were 63.5% (95% CI: 51.5% - 74.2%) and 78.1% (95% CI: 65.7% - 87.1%), respectively. While the sensitivity and specificity rates at identifying treatment-requiring ROP were 76.9% (95% CI: 45.9% - 93.8%) and 46.4% (95% CI: 37.5% - 55.5%), respectively. @*Conclusion@#WINROP is fairly sensitive and specific in predicting any-stage ROP but has fair sensitivity and poor specificity in predicting treatment-requiring ROP. WINROP may aid in ROP prediction, but regular screening of preterm infants at risk for ROP based on current criteria remains to be the standard of care.

Analysis of prenatal and postnatal risk factors of retinopathy of prematurity in a tertiary care hospital in South India.

Context: Recent advances in neonatology have influenced the incidence and severity of ROP in a dichotomous fashion. Aims: To determine the incidence of ROP and to analyse its risk factors. Settings and Design: Prospective clinical case series. Materials and Methods: 282 preterm infants with birthweight < 1500g and/or gestational age ≤ 32 weeks and also those with gestational age > 32 weeks, with birthweight between 1500‑2000 g, who were at risk for ROP were selected. Weight gain proportion was measured as weight at 6 weeks minus birthweight divided by birthweight. Statistical Analysis: Univariate and multivariate logistic regression. Results: Incidence of any ROP was 21.6% while severe ROP was 6.7%. Prenatal factors like multiple gestation (P = 0.510) and antenatal steroids (P = 0.104) were not significantly associated with ROP. On multivariate analysis, postnatal factors like weight at birth < 1250 g (P = 0.01) and gestational age between 31‑32 weeks (P = 0.02) were independent risk factors for any ROP, while intraventricular hemorrhage (P = 0.03) was the only independent risk factor for severe ROP. Mean birthweight of infants with severe ROP was 1056 ± 207 g (P = 0.004), which was significantly low. After logistic regression, the mean weight gain proportion at 6 weeks, of those neonates with severe ROP was 30%. Conclusions: Low birthweight and prematurity were the most important risk factors for developing any ROP, while intraventricular hemorrhage was the independent risk factor for developing severe ROP. The mean postnatal weight gain at 6 weeks was not statistically significant in neonates with severe ROP.

Association between Weight Gain and the Occurrence and Severity of Retinopathy of Prematurity

PURPOSE: To evaluate the association between the occurrence and severity of retinopathy of prematurity (ROP) and postnatal weight gain. METHODS: The medical records and mean rate of postnatal weekly weight gain measurements for 275 premature infants were retrospectively reviewed. According to fundus examination findings, 275 infants were divided into the following three groups according to the international classification of ROP: Group I; infants with no ROP, Group II; infants with mild ROP (stage 1 or stage 2 with no additional disease or spontaneous regression), and Group III; infants with moderate to severe ROP (stage 3, threshold or Type I ROP according to ET-ROP). The mean rates of postnatal weekly weight gain in each group were compared and other risk factors were evaluated. RESULTS: There was a tendency of decrement in the mean rate of postnatal weekly weight gain in association with the severity of the disease (Group I: 13.54 +/- 11.87%; Group II: 12.38 +/- 1.33%; Group III: 11.41 +/- 1.70%) but no statistical significance was found. Additionally, there was no statistically significant difference between the group without ROP and the group with ROP. Significant risk factors related to ROP were low birth weight, low gestational age, low Apgar score, long duration of oxygen therapy, high incidence of respiratory distress syndrome and bronchopulmonary dysplasia. CONCLUSIONS: The change in postnatal weight gain has limited usage as a main prognostic factor in predicting the progression of ROP.