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Validation of the postnatal growth and retinopathy of prematurity screening criteria
Sean Wadley1, Matthew Recko1, Shoji Samson2
1Department of Ophthalmology, Baylor Scott & White Medical Center - Temple, Temple, Texas.
Insights
The Postnatal Growth and Retinopathy of Prematurity Study criteria effectively screened infants for retinopathy of prematurity (ROP), identifying all type 1 and type 2 ROP cases. This approach reduced the number of infants needing ROP examinations by 35.7%.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of vision impairment in premature infants.
- Current screening criteria aim to detect ROP early but may lead to over-screening.
- Validating existing criteria in new populations is crucial for optimizing ROP care.
Observation:
- A retrospective study validated the Postnatal Growth and Retinopathy of Prematurity Study screening criteria in 484 high-risk infants.
- The study period spanned from January 2014 to December 2019 at a single academic medical center.
- Infants were assessed for type 1 and type 2 ROP based on Early Treatment of Retinopathy of Prematurity Study definitions.
Findings:
- The criteria demonstrated 100% sensitivity in identifying both type 1 and type 2 ROP.
- Application of the criteria reduced the number of infants requiring ROP examinations by 35.7%.
- This reduction suggests potential for significant cost savings and fewer unnecessary procedures.
Implications:
- The Postnatal Growth and Retinopathy of Prematurity Study criteria are generalizable and effective in a new cohort.
- Implementing these criteria can optimize ROP screening protocols, reducing patient burden and healthcare costs.
- This validation supports wider adoption of these evidence-based screening guidelines.
Abstract:
The objective of this study was to validate the generalizability of the Postnatal Growth and Retinopathy of Prematurity Study screening criteria in a new cohort of infants at risk for retinopathy of prematurity (ROP). This retrospective validation study conducted at a single academic medical center included 484 infants at risk for ROP born between January 14, 2014, and December 21, 2019. The primary outcomes evaluated were sensitivity for both type 1 and type 2 ROP, as defined by the Early Treatment of Retinopathy of Prematurity Study, as well as the reduction in total number of infants requiring ROP examinations. Secondary outcomes included the total number of ROP examinations avoided and the potential cost reduction of eliminating these examinations. In a cohort of 484 infants at risk for ROP, the criteria identified 40 of 40 (100%, 95% confidence interval 91.19%-100%) type 1 ROP cases and 27 of 27 (100%, 95% confidence interval 87.23%-100%) type 2 ROP cases while reducing the total number of infants screened by 35.7%. The Postnatal Growth and Retinopathy of Prematurity Study criteria were found in this study to be generalizable to a cohort of infants at a single teaching institution in central Texas. If applied during the studied interval, these criteria could have significantly reduced the number of infants undergoing ROP examinations and maintained excellent sensitivity for type 1 ROP.
