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Risk Calculator for Retinopathy of Prematurity Requiring Treatment
Maria J Chaves-Samaniego1,2, Mar García Castejón3, Maria C Chaves-Samaniego4
1Doctoral Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain.
Insights
Early vascular delay in retinopathy of prematurity (ROP) increases treatment risk. Longer mechanical ventilation (MV) and larger temporal avascular areas in premature infants significantly predict ROP requiring treatment.
Area of Science:
- Ophthalmology
- Neonatology
- Perinatal Medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of visual impairment in premature infants.
- Early vascular delay is a critical risk factor for developing ROP that necessitates treatment.
- Identifying predictive factors for ROP is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To investigate the association between ROP requiring treatment and key risk factors.
- To quantify the impact of temporal avascular area and mechanical ventilation duration on ROP treatment necessity.
- To develop a predictive model for ROP treatment risk in premature newborns.
Main Methods:
- An observational retrospective case-control study was conducted.
- Retinal examinations were performed on 228 premature infants at 4 and 6 postnatal weeks.
- Temporal avascular area (in disc diameters) and mechanical ventilation duration (in days) were measured.
Main Results:
- Increased duration of mechanical ventilation was significantly associated with a higher risk of ROP requiring treatment (8.1% increase per day).
- A larger temporal avascular area was also strongly correlated with increased ROP treatment risk (111% increase per disc diameter).
- An online calculator and table were developed to estimate ROP treatment risk based on these factors.
Conclusions:
- The temporal avascular area and duration of mechanical ventilation are significant predictors of ROP requiring treatment.
- These factors should be considered during initial newborn examinations to assess ROP risk.
- Early identification of high-risk infants can guide proactive management and potentially prevent severe visual outcomes.
Abstract:
Importance: Vascular delay that occurs early in the development of retinopathy of prematurity (ROP) is a risk factor that can be compensated by ensuring a good rate of retinal vascularization to avoid ROP that requires treatment. Background: The objective of the present study was to determine the association between ROP that requires treatment and risk factors such as the extent of the temporal avascular area of the retina and the number of days of mechanical ventilation (MV). Design: Observational retrospective case-control study. Participants: Two hundred and twenty-eight premature newborns included in the screening protocol for retinopathy of prematurity. Methods: Subjects underwent retinal examination in the 4 and 6th postnatal weeks. Main Outcome Measures: The temporal avascular area was measured in disc diameters (DD), while the MV time was measured in days of treatment. Results: Patients with a longer MV time had a higher risk of treatment (R 2: 24.7, p < 0.0001; increase in risk of 8.1% for each additional day), as did those who showed greater avascular area (R 2: 24.7, p < 0.0001; increase in risk of 111% for each additional DD). An online calculator system and a table are presented for calculating the risk of ROP requiring treatment as a function of these two risk factors. Conclusions and Relevance: The temporal avascular area of the retina and MV time must be taken into account in the first examination of the newborn to predict the need for ROP treatment.
