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Gil Binenbaum, James Shaffer, Lauren Tomlinson, Gui-Shuang Ying; Modified Screening Criteria for Retinopathy of Prematurity: Primary Results of the G-ROP Study. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2786. doi: https://doi.org/.
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Current retinopathy of prematurity (ROP) screening guidelines, based on studies of high-risk infants and expert opinion, have low specificity for disease requiring treatment. Postnatal-weight-gain-based models improve specificity but their clinical use has been limited by complexity, small development cohorts, and decreased sensitivity in validation studies. We sought to develop birth weight (BW), gestational age (GA), and weight-gain (WG) ROP screening criteria, using data from a large, broad-risk cohort of premature infants.
We conducted a retrospective multicenter study of 7,483 premature infants at risk for ROP at 29 hospitals in the United States and Canada. A hybrid modeling approach was used, combining BW/GA criteria; weight comparison to expected growth from infants without ROP; multiple growth-interval assessments; consideration of non-physiological WG; and user-friendly screening criteria. Numerous BW/GA levels, postnatal-age periods, time-intervals, and WG-percentile thresholds were evaluated to identify the most robust parameters. The primary outcome measures were sensitivity for ETROP Study Type 1 ROP and the potential reduction in infants requiring examinations.
Infants meeting any of 6 criteria would undergo examinations: GA<28wks; BW<1051g; WG<120g, <180g, or <170g during ages 10-19, 20-29, or 30-39 days, respectively; or hydrocephalus. These criteria predicted 459/459 Type 1 (sensitivity 100%, 95%CI 99.2-100%), 524/524 treated, and 466/472 Type 2 cases, while reducing infants requiring examinations by 30.3% (2,269 infants).
This large cohort, broadly representative of infants undergoing ROP examinations, provides evidence-based screening criteria. With validation, the G-ROP criteria could be incorporated into ROP screening guidelines to reduce infants requiring examinations in North America.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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