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Optimised multivariable prediction model to predict treatment requirement in preterm infants with retinopathy of

Taku Toyama1,2, Han Peng Zhou3, Sao Sugimoto3

  • 1Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan. toyama.ophthalmol@gmail.com.

Eye (London, England)
|January 19, 2026
PubMed

Insights

A new model identifies premature infants at low risk for retinopathy of prematurity (ROP) from 32 weeks postmenstrual age. This tool can potentially halve the number of infants needing frequent eye exams, reducing healthcare burdens.

Area of Science:

  • Neonatal Ophthalmology
  • Medical Informatics
  • Biostatistics

Background:

  • Retinopathy of prematurity (ROP) is a primary cause of blindness in premature infants.
  • Frequent fundus examinations for ROP screening pose significant burdens on neonates, families, and healthcare systems.
  • Developing predictive models can help identify low-risk infants, optimizing screening protocols.

Purpose of the Study:

  • To develop and validate a predictive model for identifying infants at low risk of retinopathy of prematurity (ROP).
  • To reduce the number of infants requiring intensive screening through early risk stratification.

Main Methods:

  • A retrospective cohort study of 298 preterm infants (birth weight ≤1800g or gestational age <34 weeks) was conducted.
  • Fourteen clinical and laboratory variables were evaluated at 28, 30, 32, and 34 postmenstrual weeks.
  • Logistic regression and Akaike Information Criterion were used to select the optimal predictive model, with ROC analysis for threshold determination.

Main Results:

  • The optimal model incorporated gestational age, sex, growth velocity, maximum NLR, minimum platelet count, and maximum PLR.
  • Model performance (AUC) improved with postmenstrual age, reaching 0.85 at 34 weeks.
  • Evaluations at 32 and 34 weeks demonstrated the potential to reduce infant examinations by approximately 50% while maintaining high sensitivity.

Conclusions:

  • A validated model can identify low-risk infants for ROP from 32 weeks postmenstrual age, potentially halving the need for fundus examinations.
  • All predictors utilized in the model are routinely available in neonatal intensive care units (NICUs).
  • External validation in diverse prospective cohorts is recommended prior to clinical implementation.
Abstract

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