Related Experiment Video
Updated: Jul 26, 2025
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
Validation and Feasibility of the Postnatal Growth and Retinopathy of Prematurity Retinal Screening Criteria at a
Barbara Johnson1, Abhishek Makkar1, Rachel Sessler1
1Department of Pediatrics, Neonatal Perinatal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Insights
The G-ROP algorithm accurately predicts retinopathy of prematurity (ROP) in preterm infants, identifying all treatment-warranted cases. This approach can safely reduce screenings by 50% and hospital costs.
Area of Science:
- Ophthalmology
- Neonatology
- Health Economics
Background:
- Standardized screening for retinopathy of prematurity (ROP) in preterm infants often lacks sensitivity.
- The Postnatal Growth and Retinopathy of Prematurity (G-ROP) algorithm shows promise for improved ROP prediction using weight gain.
Purpose of the Study:
- To validate the G-ROP algorithm's sensitivity for ROP detection in infants born after 28 weeks' gestation in a US tertiary care setting.
- To assess the potential cost savings from reduced ROP examinations using the G-ROP criteria.
Main Methods:
- Retrospective analysis of retinal screening data from infants born >28 weeks' gestation (2014-2019).
- Post-hoc application of G-ROP criteria to evaluate sensitivity and specificity for Type 1 and Type 2 ROP.
- Estimation of cost savings based on billing codes and reduced examination frequency.
Main Results:
- G-ROP criteria demonstrated 100% sensitivity for Type 1 ROP and 87.6% for Type 2 ROP.
- Implementing G-ROP could reduce infant screenings by 50%, with a projected 49% cost saving.
- All infants requiring treatment in the second tier were successfully identified.
Conclusions:
- The G-ROP criteria are feasible for real-world application and can safely screen for ROP.
- While all Type 1 ROP cases were detected, some Type 2 cases were missed.
- Adoption of G-ROP guidelines offers significant potential for hospital cost savings and reduced unnecessary examinations.
Objective:
Retinopathy of prematurity (ROP) is detected in preterm infants by standardized screening programs, but in general, they have poor sensitivity. The Postnatal Growth and Retinopathy of Prematurity (G-ROP) algorithm uses weight gain to predict ROP superior reported sensitivity. Our objectives are to (1) independently validate the sensitivity of G-ROP criteria for the detection of ROP in infants born at >28 weeks' gestation in a tertiary care unit in the United States and (2) to calculate the cost savings associated with a potential reduction in examinations.
Study Design:
This is a retrospective analysis of retinal screening examination data, with post-hoc application of G-ROP criteria to determine whether G-ROP criteria had acceptable sensitivity and specificity in diagnosing Type 1 and Type 2 ROP. All infants born at >28 weeks who were screened by current American Academy of Pediatric Ophthalmologists/American Academy of Pediatrics guidelines at Oklahoma Children's Hospital at the University of Oklahoma Health Sciences Center, between 2014 and 2019, were included. Subset analysis of infants screened by second tier criteria was also performed. Potential cost savings were estimated by analyzing frequency of billing codes. And by calculating the number of infants who could have potentially been spared examination.
Results:
The G-ROP criteria had 100% sensitivity in detecting type 1 and 87.6% sensitivity in detecting type 2 ROP, which would have reduced infants screened by 50%. All infants in the second tier who would require treatment were detected. A cost saving of 49% was projected.
Conclusion:
The G-ROP criteria are easy to apply in real-world setting, thus establishing feasibility. The algorithm identified all cases of type 1 ROP; however, some cases of type 2 ROP were not detected. The annual savings in hospital examination cost by using these criteria would be 50%. Therefore, G-ROP criteria can safely be used to screen for ROP and may reduce the number of unnecessary examinations.
Key Points:
· The G-ROP screening criteria are safe and predict 100% of treatment warranted ROP.. · Adoption of G-ROP criteria is feasible for level IV NICUs.. · Adoption of G-ROP screening guidelines will result in significant cost savings..
