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Validation of the Postnatal Growth and Retinopathy of Prematurity (GROP) screening criteria
Kaveh Fadakar1, Haider Abbas1, Sahel Soltani Shahgoli1
1Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.
Insights
The G-ROP screening criteria effectively identified premature infants needing retinopathy of prematurity (ROP) treatment with 100% sensitivity. While specific for excluding infants without ROP, further studies are needed to optimize its use in neonatal intensive care units (NICUs).
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a primary cause of irreversible infant blindness.
- The Postnatal Growth and ROP (G-ROP) study introduced novel screening criteria for ROP.
- This study validates the G-ROP criteria in Iranian premature infants requiring extended neonatal intensive care unit (NICU) stays.
Purpose of the Study:
- To validate the G-ROP screening criteria for retinopathy of prematurity (ROP) in a cohort of Iranian premature infants.
- To assess the sensitivity and specificity of the G-ROP criteria in identifying infants who require ROP treatment.
- To compare the G-ROP criteria against existing Iranian and North American ROP screening guidelines.
Main Methods:
- Retrospective analysis of data from 166 premature infants admitted to the NICU between January 2020 and December 2021.
- Screening for ROP using Iranian national criteria, followed by application of G-ROP criteria.
- Evaluation of G-ROP criteria's sensitivity and specificity for ROP detection and treatment prediction, with comparative analysis against other guidelines.
Main Results:
- The G-ROP criteria identified 97.69% of infants with ROP and 100% of those requiring treatment.
- Specificity for excluding infants without ROP was low (8.33%), with only 3 out of 36 correctly excluded.
- Compared to Iranian and North American criteria (100% sensitivity, 0% specificity for detecting any ROP), G-ROP showed a 100% sensitivity for treatment-requiring ROP.
Conclusions:
- The G-ROP screening criteria demonstrate high sensitivity (100%) for detecting infants requiring ROP treatment within a high-risk population.
- The specificity of the G-ROP criteria for excluding infants not requiring treatment needs improvement.
- Further research with larger cohorts is recommended to confirm the potential of G-ROP criteria in reducing the burden of retinal examinations for premature infants.
Background:
Retinopathy of prematurity (ROP) is a leading cause of irreversible blindness in infants. The Postnatal Growth and ROP (G-ROP) study proposed new screening criteria for ROP. This study aimed to validate the G-ROP screening criteria in a group of Iranian premature infants who were treated in the neonatal intensive care unit (NICU) for at least 40 days.
Methods:
In this retrospective study, we extracted the data pertaining to infants admitted to the NICU from January 2020 to December 2021. We screened all the included infants for ROP based on the Iranian national screening criteria. We applied the G-ROP criteria to our study population, and if no criterion was met, the infant was exempted from ROP screening. We determined the sensitivity and specificity of the G-ROP guidelines for ROP detection, along with its capacity for predicting the requirement for ROP treatment. Moreover, we compared the G-ROP guidelines with the Iranian and North American guidelines for ROP screening.
Results:
A total of 166 premature infants with complete datasets were included: 130 had ROP, of whom 61 were treated. There were 109 female infants (65.7%). The mean (standard deviation [SD]) birth weight and gestational age were 1080 (256) g and 28.28 (1.97) weeks, respectively. Applying the G-ROP criteria, 127 of 130 infants with ROP were identified (sensitivity, 97.69%; 95% confidence interval [CI], 95.11% - 100%), and of 36 infants without ROP, three were correctly excluded (specificity, 8.33%; 95% CI, 0% - 17.36%). The G-ROP criteria did not fail to identify infants who required treatment for ROP (sensitivity, 100%; 95% CI, 98.29 - 100) and had a specificity of 8.69% (95% CI, 2.04% - 15.34%). Although the Iranian and North American criteria had 100% sensitivity for infants with any stage of ROP, they could not detect infants without ROP (0% specificity).
Conclusions:
The G-ROP screening criteria had a sensitivity of 100% in identifying infants requiring treatment for ROP in our high-risk group; however, specificity was not sufficiently high. Further studies with larger numbers of referred infants could confirm a decrease in the burden of retinal examinations using these criteria.
