Validation of the 'TWO-ROP' algorithm in a tertiary Care Centre in Greece

Area of Science:

• Ophthalmology
• Neonatal care
• Public health

Background:

• Retinopathy of prematurity (ROP) screening is crucial for premature infants.
• Current screening protocols can be burdensome for healthcare systems and families.
• The TWO-ROP algorithm was developed in the US to streamline ROP screening for low-risk infants.

Purpose of the Study:

• To validate the efficacy and safety of the TWO-ROP algorithm in an external, non-US dataset.
• To assess the potential of the TWO-ROP algorithm to reduce ROP screening burden in Greece.
• To evaluate the algorithm's performance in identifying infants requiring treatment for ROP.

Main Methods:

• Retrospective study of premature infants screened for ROP at a Greek tertiary center.
• Infants were stratified into three groups based on birth weight and gestational age.
• Rates of ROP and Type 1 ROP were evaluated according to the TWO-ROP algorithm criteria.

Main Results:

• 14.6% of ROP examinations were saved by applying the TWO-ROP algorithm.
• No cases of Treatment-Warranted ROP (TW-ROP) were identified, indicating no missed cases.
• ROP was detected in 2.5% of infants, with no cases meeting criteria for Type 1 ROP.

Conclusions:

• The TWO-ROP algorithm demonstrates safety and effectiveness in reducing ROP screening examinations in Greece.
• This first ex-US validation supports the global applicability of risk-stratified screening for ROP.
• The algorithm offers a valuable tool for optimizing resource utilization in neonatal eye care worldwide.