The Alexandria retinopathy of prematurity model (Alex-ROP): postnatal weight gain screening algorithm application in...

Area of Science:

• Neonatal ophthalmology
• Public health
• Pediatric screening

Background:

• Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
• Current screening methods in developing countries often lack optimal sensitivity and specificity.
• Postnatal weight gain is a crucial indicator of infant health and development.

Purpose of the Study:

• To propose a novel ROP screening model for developing countries.
• To integrate postnatal weight gain ratios (PWGR) with traditional screening parameters.
• To enhance ROP detection by improving specificity while maintaining high sensitivity.

Main Methods:

• Analysis of weekly PWGR in infants over six months.
• Identification of the optimal age for PWGR assessment (postnatal net weight gain ratio - NWGR).
• Development of the Alex-ROP model incorporating NWGR and conventional criteria.

Main Results:

• NWGR at 28 days post-birth emerged as the most predictive factor for ROP.
• The Alex-ROP model suggests screening infants with gestational age ≤33 weeks or birth weight ≤1500 g and NWGR <0.3 at 28 days.
• The High-grade Alex-ROP (Hg Alex-ROP) model for severe ROP uses NWGR <0.15 between birth and 28 days.

Conclusions:

• The Alex-ROP and Hg Alex-ROP models offer practical improvements for ROP screening in resource-limited settings.
• These models enhance screening specificity without compromising sensitivity.
• The models are easily applicable, aiding in better ROP management in developing countries.