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W. W. Phillips, S. Gupta, S. K. Chalam, S. Grover; Evaluation of Modified Retinopathy of Prematurity (ROP) Using Birth-Weight (BW) as Sole Inclusion Criteria. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4061.
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The aim of this study is to evaluate BW of less than or equal to 1250g as a sole criteria for screening of ROP.
We retrospectively analyzed charts of 561 infants screened for ROP in the tertiary care neonatal intensive care unit of our university hospital, using AAPOS guidelines. Eyes were staged according to the International Classification for ROP. Variables examined included BW, GA, and BWGA Index [(BW in kg x GA in weeks) / 1000]. Univariate and multivariate analyses were performed to detect factors predictive of ROP. Receiver Operator Characteristic (ROC) curves were generated to find the efficacy of screening using the BW, GA, and BWGA Index. Infants were divided into Group 1: GA <1250g and Group 2: GA>1250g.
352 (31.2%) eyes of 176 infants had some form of ROP. All eyes with stage 3 and higher ROP were in Group 1. 162 (14.4%) eyes had a maximum stage (MS) ROP of 1, 140 (12.4%) eyes had MS 2, 46 (4.1%) eyes had MS 3, 2 eyes (0.17%) had MS 4 and 6 (0.53%) eyes had MS 5. Using the AAO joint guidelines with our population gave a sensitivity of 98.2%, specificity of 81.4%, a positive predictive power of 31.7%, and a negative predictive value (NPP) of 99.8%. Using BW < 1250 alone as a screening parameter, the sensitivity was 88.2%, specificity 89.8%, positive predictive value (PPV) 44.1%, and a negative predictive value (NPP) of 99.2%.
Using BW alone is just as efficient in detecting high risk ROP as using the combined criteria of BW and GA. AUC estimates for each of BW, GA, BWGA index, were similar, and showed that the variables under consideration have good overall screening power.
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