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A new risk-based screening criterion for treatment-demanding retinopathy of prematurity in Denmark
Carina Slidsborg1, Julie Lyng Forman, Steen Rasmussen
1Department of Ophthalmology, Glostrup Hospital, Nordre Ringvej 57, 2600 Glostrup, Denmark. carinaslidsborg@hotmail.com
Insights
A new risk-based criterion for retinopathy of prematurity screening in Denmark is highly effective. Implementing a 0.13% risk threshold safely identifies all infants needing treatment while reducing the number screened.
Area of Science:
- Neonatology
- Ophthalmology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current screening protocols in Denmark may not be optimally effective or safe.
- Identifying the best screening criteria is crucial for early intervention and preventing blindness.
Purpose of the Study:
- To determine the most effective and safe screening criterion for retinopathy of prematurity in Denmark.
- To evaluate risk-based screening criteria against traditional methods.
Main Methods:
- Retrospective national cohort study using data from 3 national registers.
- Analysis of infants treated for ROP, those missed by screening, and candidates for ROP development.
- Nonlinear logistic regression model to evaluate various screening criteria.
Main Results:
- Risk-based criteria were more effective than gestational age and birth weight limits.
- A 0.13% risk-based criterion detected all treated infants and reduced the screened population by 17.4%.
- This criterion is predicted to miss 1 case of treatment-demanding ROP every 11 years and cause 1 case of blindness every 18 years.
Conclusions:
- Risk-based screening criteria are superior for ROP detection.
- A 0.13% risk threshold is a safe and effective criterion for ROP screening in Denmark.
Objective:
The aim of this study was to uncover the most effective and safe criterion to implement for retinopathy of prematurity screening in Denmark.
Methods:
This retrospective national cohort study is based on data from 3 national registers. These registers provided on infants treated for retinopathy of prematurity, infants in need of treatment but missed by the present screening program, and the candidate neonates for advanced retinopathy of prematurity development A nonlinear logistic regression model was fitted to the data, and various screening criteria were evaluated.
Results:
During the study period (2002-2006), 116 infants were treated for retinopathy of prematurity, no treatment-demanding retinopathy of prematurity infants were missed by the screening program, and 182 premature infants were candidates for developing treatment-demanding retinopathy of prematurity. Screening criteria combining gestational age at delivery and birth weight limits and new risk-based criteria were compared with regards to their effectiveness. The risk-based criteria were the most effective. Use of the 0.13% risk-based criterion to define the population to be screened resulted in the detection of all treated infants in the study period and 17.4% fewer infants to screen. The model predicted this criterion to result in 1 missed case of treatment-demanding retinopathy of prematurity every 11 years and 1 case of blindness every 18 years in Denmark.
Conclusions:
Screening criteria based on risk estimates of developing treatment-demanding retinopathy of prematurity are the most effective for retinopathy-of-prematurity screening. The risk-based criterion of 0.13% can safely be implemented for future retinopathy-of-prematurity screening in Denmark.
