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Evaluating the G-ROP criteria sensitivity for type 1 ROP in a North American cohort
Omi Pang1, Nabiha Habib1, Julie Conley2
1Michigan State University College of Human Medicine, East Lansing, Michigan.
Insights
The new G-ROP criteria for retinopathy of prematurity (ROP) screening show high sensitivity but missed one case. Further research into twin-to-twin transfusion syndrome is recommended for ROP screening improvements.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Current retinopathy of prematurity (ROP) screening follows American Academy of Pediatrics (AAP) guidelines.
- The G-ROP study proposed new criteria with 100% sensitivity for type 1 ROP and a 30% reduction in examinations.
- Validation of G-ROP criteria in a diverse clinical setting is essential.
Purpose of the Study:
- To validate the G-ROP screening criteria for retinopathy of prematurity (ROP).
- To assess the sensitivity and specificity of G-ROP criteria in a midsized Midwestern children's hospital.
Main Methods:
- Retrospective cohort study of infants screened for ROP (January 2018 - December 2022).
- Application of G-ROP criteria to infants screened under AAP guidelines.
- Evaluation of G-ROP sensitivity and specificity for detecting type 1 ROP requiring treatment.
Main Results:
- 687 infants included; average gestational age 28 weeks, birthweight 1022.5g.
- 448 infants (65.2%) met G-ROP criteria.
- G-ROP sensitivity was 97.1% for type 1 ROP, missing one infant requiring treatment.
Conclusions:
- G-ROP criteria demonstrated high sensitivity but not 100% as in prior studies.
- The missed case had a history of twin-to-twin transfusion syndrome.
- Physiologic factors of twin-to-twin transfusion syndrome warrant further investigation for ROP screening optimization.
Background:
Current screening criteria for retinopathy of prematurity (ROP) follow the American Academy of Pediatrics (AAP) guidelines. However, the Postnatal Growth and Retinopathy (G-ROP) study has proposed newer criteria, showing 100% sensitivity for detecting type 1 ROP while reducing the number of infants requiring dilated retinal examinations by 30%. The purpose of this study was to validate the G-ROP criteria in a midsized Midwestern children's hospital.
Methods:
We conducted a retrospective cohort study of infants screened for ROP between January 2018 and December 2022 under AAP guidelines. We then applied the G-ROP criteria to the same cohort and evaluated the sensitivity and specificity of these guidelines for detecting type 1 ROP requiring treatment.
Results:
A total of 687 infants were included. The average gestational age 28 weeks; the average birthweight, 1022.5 g. Of the 687 infants screened by standard of care (SOC) criteria, 448 (65.2%) met G-ROP criteria. Using SOC criteria, 34 infants (4.9%) developed type 1 ROP necessitating treatment. However, when using G-ROP screening criteria, 33 of 448 (7.4%) with type 1 ROP were identified. The sensitivity of G-ROP for detecting type 1 ROP was 97.1%, but 1 infant who required treatment was missed.
Conclusions:
G-ROP criteria demonstrated high sensitivity but did not match the 100% sensitivity from earlier studies. The single infant with type 1 ROP missed by G-ROP screening had a medical history of twin-to-twin transfusion syndrome. The physiologic factors of twin-to-twin transfusion syndrome could be important to explore when considering ROP screening criteria.
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