The Colorado-retinopathy of prematurity model (CO-ROP): postnatal weight gain screening algorithm

Area of Science:

• Neonatology
• Ophthalmology
• Perinatal Medicine

Background:

• Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
• Current screening guidelines (2013) for ROP have limitations in specificity, leading to over-screening.
• A more accurate and efficient screening model is needed to optimize ROP detection and resource allocation.

Purpose of the Study:

• To introduce and evaluate a novel screening model for ROP, termed CO-ROP.
• The CO-ROP model incorporates birth weight, gestational age, and postnatal weight gain.
• To assess if CO-ROP improves specificity in detecting all grades of ROP compared to existing 2013 guidelines while maintaining sensitivity.

Main Methods:

• Retrospective review of medical records for 499 neonates meeting 2013 ROP screening criteria.
• Analysis of weekly weights using logistic regression to establish a postnatal weight gain criterion.
• Development of the CO-ROP model by combining gestational age, birth weight, and the new weight gain criterion.

Main Results:

• The CO-ROP model identified infants with gestational age ≤30 weeks, birth weight ≤1500 g, and net weight gain ≤650 g by 1 month.
• CO-ROP demonstrated 100% sensitivity for high-grade ROP and 96.4% for all ROP grades.
• Implementing CO-ROP could reduce the number of infants screened by 23.7%, with a potential 45.9% reduction if calibrated for high-grade ROP detection only.

Conclusions:

• The CO-ROP model offers a simple yet effective approach to ROP screening.
• It maintains high sensitivity for ROP detection while significantly decreasing the number of infants requiring screening.
• Despite a small sample size, CO-ROP shows promise for improving ROP screening efficiency in clinical practice and future research.