Related Experiment Video
Updated: May 29, 2026
Optimization of the Retinal Vein Occlusion Mouse Model to Limit Variability
Published on: August 6, 2021
Evaluation of modified retinopathy of prematurity screening guidelines using birth weight as the sole inclusion
Kakarla V Chalam1, Selina Lin, Ravi K Murthy
1Department of Ophthalmology, University of Florida School of Medicine, Jacksonville, FL, USA.
Insights
Birth weight alone is sufficient for screening infants at risk for retinopathy of prematurity (ROP). Using a birth weight of 1250 g or less effectively identifies infants needing ROP screening, reducing unnecessary examinations.
Area of Science:
- Neonatalogy
- Ophthalmology
- Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current screening guidelines often consider multiple factors, potentially leading to over-screening.
Purpose of the Study:
- To evaluate if birth weight (BW) alone can serve as the sole criterion for screening infants at risk for ROP.
- To determine the efficacy of BW ≤ 1250 g as a screening parameter.
Main Methods:
- Retrospective observational case series of 208 infants screened for ROP.
- Analysis of gestational age (GA), BW, and BWGA Index.
- Comparison of screening efficacy using Receiver Operator Characteristic (ROC) curves.
Main Results:
- Birth weight ≤ 1250 g identified all infants who developed stage 3 or higher ROP.
- Using BW ≤ 1250 g as a criterion reduced screenings by 24% without excluding significant ROP.
- ROC analysis showed comparable efficacy for BW, GA, and BWGA Index in ROP screening.
Conclusions:
- Birth weight ≤ 1250 g is an adequate parameter for identifying premature infants at risk for ROP.
- This criterion can streamline ROP screening protocols in neonatal intensive care units.
Purpose:
The purpose was to determine if birth weight (BW) alone can be the sole criterion for screening infants at risk for retinopathy of prematurity (ROP).
Materials And Methods:
In this retrospective, observational case series, 208 infants were screened for ROP using the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) Guidelines (1997). Variables examined included gestational age (GA), birth weight (BW), and a composite variable BWGA Index [(grams × weeks)/1000], which takes into consideration both the birth weight and gestational age of the infant. Infants were divided into two groups: Group 1, BW ≤1250 g, and Group 2, BW >1250 g. Multivariate analysis was performed to detect factors predictive of ROP. Receiver operator characteristic (ROC) curves were generated to determine the efficacy of screening using the BW, GA, and BWGA Index. Statistical analyses were performed with logistic regression with a P-value of 0.05 or less indicating statistical significance.
Results:
Varying stages of ROP were present in 116 of 416 eyes. Of the 105 eyes in Group 2, only 1 eye developed stage 1 ROP. Only Group 1 eyes developed stage 3 or higher ROP. The ROC curve for BW alone gave an area under the curve (AUC) of 0.797 (standard error [SE] = 0.0329, P < 0.0001); for GA, AUC was 0.801 (SE = 0.0340, P < 0.0001) and for the BWGA Index, the AUC was 0.808 (SE = 0.0324, P < 0.0001). Using 1250-g BW as a criterion for ROP screening would have decreased the number of screenings by 24%, and did not exclude any ROP higher than stage 1.
Conclusion:
Data from our neonatal intensive care unit suggest that birth weight ≤ 1250 g alone is an adequate parameter to identify premature infants at risk for ROP.
