Related Experiment Video
Updated: Dec 14, 2025
Author Spotlight: An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
Published on: March 17, 2023
Optimised retinopathy of prematurity screening guideline in China based on a 5-year cohort study
Qian Yang1, Xiaohong Zhou2, Yingqin Ni1
1Department of Ophthalmology, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.
Insights
Optimized retinopathy of prematurity (ROP) screening guidelines were developed using adjusted gestational age (GA) and birth weight (BW) thresholds. This new approach accurately identified ROP cases while reducing the number of infants needing examination by 43.2%.
Area of Science:
- Neonatal Ophthalmology
- Public Health
- Clinical Trial Design
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current screening guidelines for ROP may lead to over-examination and increased healthcare costs.
- Optimizing screening criteria is crucial for efficient ROP detection and management.
Purpose of the Study:
- To develop an optimized retinopathy of prematurity (ROP) screening guideline.
- To adjust screening schedules and thresholds for gestational age (GA) and birth weight (BW).
- To improve the efficiency and cost-effectiveness of ROP screening.
Main Methods:
- A multicentre retrospective cohort study analyzed data from 5606 infants born between 2012 and 2016 in Shanghai, China.
- Infants underwent ROP examinations, and data on ROP incidence, risk factors, and timing of diagnosis were collected.
- Screening models were evaluated for sensitivity and specificity using optimized criteria (GA <32 weeks or BW <1600 g).
Main Results:
- ROP was diagnosed in 15.9% of infants (892/5606), with 1.1% requiring treatment.
- The optimized criteria (GA <32 weeks or BW <1600 g) predicted 98.4% of type 1 ROP cases.
- This optimization reduced the number of infants requiring examinations by 43.2%.
Conclusions:
- The incidence of type 1 ROP and associated mean GA and BW have decreased in China.
- The proposed screening thresholds and schedule can effectively guide modifications to ROP screening guidelines.
- Implementation of these optimized guidelines can lead to significant reductions in medical costs.
Purposes:
To develop an optimised retinopathy of prematurity (ROP) screening guideline by adjusting the screening schedule and thresholds of gestational age (GA) and birth weight (BW).
Methods:
A multicentre retrospective cohort study was conducted based on data from four tertiary neonatal intensive care units in Shanghai, China. The medical records of enrolled infants, born from 2012 to 2016 who underwent ROP examinations, were collected and analysed. The incidence and risk factors for ROP were analysed in all infants. Postnatal age (PNA) and postmenstrual age (PMA) of infants, detected to diagnose ROP for the first time, were compared with the present examination schedule. The predictive performance of screening models was evaluated by internally validating sensitivity and specificity.
Results:
Of the 5606 eligible infants, ROP was diagnosed in 892 (15.9%) infants; 63 (1.1%) of them received treatment. The mean GA of ROP patients was 29.4±2.4 weeks, and the mean BW was 1260±330 g. Greater prematurity was associated with an older PNA at which ROP developed. The minimum PMA and PNA at which diagnosis of treatable ROP occurred were 32.43 and 3 weeks, respectively. The optimised criteria (GA <32 weeks or BW <1600 g) correctly predicted 98.4% type 1 ROP infants, reducing the infants requiring examinations by 43.2% when internally validated.
Conclusions:
The incidence of type 1 ROP and the mean GA and BW of ROP infants have decreased in China. The suggested screening threshold and schedule may be reliably used to guide the modification of ROP screening guideline and decrease medical costs.
