June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Evaluation of Modified Screening Criteria for Retinopathy of Prematurity in India
Author Affiliations & Notes
  • Aditi Gupta
    Oregon Health & Science University, Portland, Oregon, United States
  • Mallory Alyssa deCampos-Stairiker
    Oregon Health & Science University, Portland, Oregon, United States
  • Minn Oh
    Oregon Health & Science University, Portland, Oregon, United States
  • Aaron S Coyner
    Oregon Health & Science University, Portland, Oregon, United States
  • Susan R Ostmo
    Oregon Health & Science University, Portland, Oregon, United States
  • Praveer Singh
    Harvard University, Cambridge, Massachusetts, United States
  • Jayashree Kalpathy-Cramer
    Harvard University, Cambridge, Massachusetts, United States
  • Robison Vernon Paul Chan
    University of Illinois System, Urbana, Illinois, United States
  • Prema Sparizam
    Aravind Eye Hospital, Madurai, Tamil Nadu, India
  • Michael F Chiang
    National Eye Institute, Bethesda, Maryland, United States
  • Parag Shah
    Aravind Eye Hospital, Madurai, Tamil Nadu, India
  • J. Peter Campbell
    Oregon Health & Science University, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Aditi Gupta None; Mallory deCampos-Stairiker None; Minn Oh None; Aaron Coyner None; Susan Ostmo None; Praveer Singh None; Jayashree Kalpathy-Cramer None; Robison Chan Siloam Vision, Code O (Owner); Prema Sparizam None; Michael Chiang None; Parag Shah None; J. Peter Campbell Boston AI, Code C (Consultant/Contractor), Siloam Vision, Code O (Owner)
  • Footnotes
    Support  This work was supported by grants R01 EY19474, R01 EY031331, R21 EY031883, and P30 EY10572 from the National Institutes of Health (Bethesda, MD), and by unrestricted departmental funding and a Career Development Award (JPC) from Research to Prevent Blindness (New York, NY), and USAID and SEVA foundation.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4183 – F0243. doi:
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      Aditi Gupta, Mallory Alyssa deCampos-Stairiker, Minn Oh, Aaron S Coyner, Susan R Ostmo, Praveer Singh, Jayashree Kalpathy-Cramer, Robison Vernon Paul Chan, Prema Sparizam, Michael F Chiang, Parag Shah, J. Peter Campbell; Evaluation of Modified Screening Criteria for Retinopathy of Prematurity in India. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4183 – F0243.

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

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Abstract

Purpose : Retinopathy of Prematurity (ROP) screening criteria vary around the world based on the population at risk. Screening criteria based on birthweight (BW) and gestational age (GA) can be more broad in low- and middle-income countries like India, where ROP can be more commonly seen in less premature babies than in the US. The purpose of this project was to evaluate the effect of various screening criteria on a large population of premature babies in South India.

Methods : We analyzed two years of data from the Aravind Eye Hospital ROP telescreening program (1/1/19-12/31/20). During that period, participating neonatal care units referred babies for screening who were less than 36 weeks postmenstrual age (PMA), or less than 2000 grams, or who had other risk factors for ROP. We evaluated 3 different screening criteria for sensitivity and specificity for detecting treatment-requiring (TR) ROP: US screening criteria (<31 weeks[w] PMA or < 1500 grams[g] BW), Indian criteria (<36w or <2000g), and intermediate criteria (<34w or <1750g).

Results : The sensitivity / specificity of the 3 sets of guidelines (India, Intermediate, and US) were 100% / 13%, 100% / 40%, and 85% / 67%, respectively, as seen in the table. Of the entire screened population (N = 2714 babies), use of intermediate criteria would reduce screening burden by 38% without missing a case of TR-ROP in this population.

Conclusions : ROP screening criteria evolve as demographics and practices in a region change. Current Indian screening criteria are 100% sensitive, but nonspecific, and US screening criteria are insufficiently sensitive for implementation in this Indian population. An intermediate cutoff produced 100% sensitivity with 38% reduced screening burden and can be considered in the future if 100% sensitivity can be ensured.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Table: Sensitivity and Specificity For Different Criteria

Table: Sensitivity and Specificity For Different Criteria

 

Figure: Distribution of Babies With and Without Treatment Requiring ROP According to GA and BW, Shaded Portion Representing Babies Not Screened by the Different Criteria

Figure: Distribution of Babies With and Without Treatment Requiring ROP According to GA and BW, Shaded Portion Representing Babies Not Screened by the Different Criteria

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