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Prediction of ROP Treatment and Evaluation of Screening Criteria in VLBW Infants-a Population Based Analysis

Roland Gerull1, Viviane Brauer2, Dirk Bassler3

  • 1Department of Neonatology, University of Basel, Children's Hospital UKBB, 4056, Basel, Switzerland. roland.gerull@ukbb.ch.

Pediatric Research
|September 7, 2018
PubMed

Insights

Screening for retinopathy of prematurity (ROP) in preterm infants may be reduced. New criteria could potentially decrease screening by 13.2% while maintaining high sensitivity for ROP treatment.

Area of Science:

  • Neonatal ophthalmology
  • Perinatal medicine
  • Public health

Background:

  • Retinopathy of prematurity (ROP) incidence and screening guidelines vary globally.
  • Current ROP screening protocols may not be optimized for local epidemiological data.
  • Assessing ROP screening reduction based on incidence is crucial for resource allocation.

Purpose of the Study:

  • To evaluate the potential for reducing ROP screening in preterm infants.
  • To develop and validate a model for identifying infants requiring ROP treatment.
  • To determine if ROP screening criteria can be refined based on local ROP incidence.

Main Methods:

  • Observational cohort study of infants born before 32 weeks gestation in Switzerland (2006-2015).
  • Analysis of chronological and postmenstrual ages at ROP treatment.
  • Development and validation of a predictive model for ROP treatment using training (2006-2012) and validation (2013-2015) datasets.

Main Results:

  • A total of 6719 preterm infants were analyzed after excluding early mortality.
  • Screening before 60 days chronological or 37 3/7 weeks postmenstrual age identified all ROP treatment cases.
  • A model achieved 95.0% sensitivity and 87.6% specificity, predicting a 13.2% reduction in screening.
  • The model demonstrated good predictive accuracy (c-statistic = 0.916).

Conclusions:

  • A significant reduction in infants requiring ROP screening appears feasible.
  • Implementation of revised screening criteria requires prospective validation.
  • Optimizing ROP screening protocols can improve efficiency and resource utilization.
Abstract

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