June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Validation of the Postnatal Growth and Retinopathy of Prematurity modified criteria in Latin American infants
Author Affiliations & Notes
  • Ellis Bloom
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Peiying Hua
    Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Luz Consuelo Zepeda-Romero
    Ophthalmology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
  • Maria Marta Galan
    Ophthalmology, Hospital de Ninos S.M. Ludovica, La Plata, Argentina
  • Judith Espinoza Navarro
    Ophthalmology, Hospital de la Mujer, Mexico City, Mexico
  • Alejandra de Alba Campomanes
    Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Lauren Tomlinson
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Gui-Shuang Ying
    Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Gil Binenbaum
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
    Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Ellis Bloom, None; Peiying Hua, None; Luz Consuelo Zepeda-Romero, None; Maria Marta Galan, None; Judith Espinoza Navarro, None; Alejandra de Alba Campomanes, None; Lauren Tomlinson, None; Gui-Shuang Ying, None; Gil Binenbaum, None
  • Footnotes
    Support  NIH grants K12 EY015398, L30 EY018451-03, 2-P30-EY01583-26, UL1-RR-024134; Bayer Global Ophthalmology Award Program, Pan-American Ophthalmological Foundation, Richard Shafritz Chair in Ophthalmology Research
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2186. doi:
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      Ellis Bloom, Peiying Hua, Luz Consuelo Zepeda-Romero, Maria Marta Galan, Judith Espinoza Navarro, Alejandra de Alba Campomanes, Lauren Tomlinson, Gui-Shuang Ying, Gil Binenbaum; Validation of the Postnatal Growth and Retinopathy of Prematurity modified criteria in Latin American infants. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2186.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the performance of the Postnatal Growth and Retinopathy of Prematurity (G-ROP) modified screening criteria in Latin America. The G-ROP criteria demonstrated greater sensitivity and specificity for predicting severe ROP than conventional ROP guidelines in the US and Canada. However, characteristics of infants with severe ROP differ in middle-income countries, and prior growth models have not performed well in such settings.

Methods : Secondary analysis of a prospective cohort study of infants screened for ROP between 2012-2014 in Guadalajara, Mexico and La Plata, Argentina. The G-ROP criteria were applied with a single, conservative weight gain threshold of 180g. Babies meeting one or more of the following criteria would receive examinations: gestational age (GA) <28wks; birth weight (BW) <1051g; weight gain<180g during postnatal ages 10-19, 20-29, or 30-39 days; or hydrocephalus. Primary outcomes were sensitivity for severe ROP (Type 1, 2, or treated) and reduction of infants receiving ROP examinations. An a priori plan was made to update the model if sensitivity was not maintained at 100%.

Results : Among 112 infants studied (median BW 1413 (range 620-2390) g; median GA 33 wks (range 25-37)), the G-ROP criteria correctly predicted 16/19 babies with severe ROP (sensitivity, 84.2%; 95% CI, 60.4%-96.6%), while decreasing babies qualifying for examinations by 33.9% (95% CI, 25.8%-43.1%). When updated, with the weight gain threshold set at <210 g for any of the three 10-day periods, sensitivity increased to 100% (95% CI, 82.4%-100%) and the reduction in babies qualifying for examinations was 27.7% (95% CI, 20.2%-36.6%).

Conclusions : The G-ROP criteria initially exhibited poor sensitivity for severe ROP. With updating, it was possible to achieve 100% sensitivity and maintain a significant benefit of fewer babies requiring examinations. However, the lower CI boundary for sensitivity was low, and excessive oxygen use may still prove to be a confounding factor. Therefore, the updated criteria need to be evaluated in a much larger validation study before they could be used clinically.

This is a 2020 ARVO Annual Meeting abstract.

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