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S.J. Lin, V.A. Shah, G.Y. Shah, P. Wludyka, K.V. Chalam; Evaluation of Modified Retinopathy of Prematurity(ROP) Screening Guidelines Using Birth–Weight(BW) as Sole Inclusion Criteria . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4100.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To determine the sensitivity and efficacy of birth weight (BW) 1250 grams as an inclusion criteria for ROP screening in order to reduce unnecessary screenings. Methods:We retrospectively analyzed charts of 268 infants screened for ROP using AAPOS guidelines. Variables examined included BW, gestational age (GA), and BWGA Index [(BW in kg x GA in weeks) / 1000]. Univariate and multivariate analysis was 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 ≤ 1250 grams (g) and Group 2: GA > 1250g. Results: 150 (27.9%) eyes had some form of ROP. Of the 64 (23.8%) infants in Group 2, only one infant (0.4%) developed ROP stage 1. All eyes with stage 3 and higher ROP were in Group 1. Seventy (46.6%) eyes had a maximum stage (MS) ROP of 1, 45 (30.2%) eyes had MS 2, 31 (20.7%) eyes had MS 3, 2 eyes (2.0%) had MS 4 and 1 (0.9%) eye had MS 5. ROC curve for BW alone gave an area under curve (AUC) = 0.797 (SE = 0.0329, p<0.0001), for GA, AUC = 0.801 (SE = 0.0340, p<0.0001) for BWGA Index, AUC = 0.808 (SE = 0.0324 ,p<0.0001). Using BW ≤1250 alone as a screening parameter with our population, the sensitivity was 98.3% (95% CI: 90.8% to 100.0%), specificity 32.7% (95% CI 25.2% to 40.8%), positive predictive value of 35.1%, negative predictive value of 98.1% and an efficiency of 51.0%. Conclusions:Using 1250g BW as criteria for ROP screening would have decreased the number of screenings by 24%, while detecting all high–risk infants except one infant with stage 1 ROP. Using BW of 1250g or less may be an efficient screening parameter in identifying infants at higher risk for ROP
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