Screening and novel therapies for retinopathy of prematurity - A review

Area of Science:

• Neonatal ophthalmology
• Perinatal medicine
• Biostatistics

Background:

• Current screening for sight-threatening retinopathy of prematurity (ROP) is extensive, with less than 10% of screened infants requiring treatment.
• Existing prediction models for ROP treatment risk incorporate factors like birth characteristics and postnatal weight gain.
• There is a need for more efficient screening protocols to reduce examinations in low-risk infants.

Purpose of the Study:

• To develop and validate an advanced statistical prediction model for ROP treatment risk.
• To assess if birth characteristics alone can predict ROP treatment risk as effectively as models including weight measurements.
• To identify the peak age for ROP treatment risk.

Main Methods:

• Utilized advanced statistical methods on data from over 7000 infants in the Swedish ROP registry.
• Developed a prediction model based initially on birth characteristics.
• Compared the predictive performance of the birth characteristics-only model with models incorporating weight measurements.

Main Results:

• A prediction model based solely on birth characteristics demonstrated comparable accuracy in predicting ROP treatment risk to models that include weight measurements.
• The risk of requiring ROP treatment peaked at 12 weeks of age.
• Laser therapy remains the primary treatment for severe ROP, while anti-VEGF therapies are used globally with ongoing research into optimal use and long-term effects.

Conclusions:

• Birth characteristics alone are powerful predictors of ROP treatment risk, potentially simplifying screening protocols.
• The findings suggest that ROP screening can be optimized by focusing on specific predictive factors and timing.
• Further research is ongoing into ROP prevention strategies, including oxygen management, breastfeeding, and nutritional/hematological interventions.