Prediction of Retinopathy of Prematurity Using the Screening Algorithm WINROP in a Mexican Population of Preterm Infants

Zepeda-Romero, Luz Consuelo; Hård, Anna‐Lena; Gómez-Ruiz, Larissa María; Gutiérrez-Padilla, José Alfonso; Angulo-Castellanos, Eusebio; Barrera-de-León, Juan Carlos; Ramirez-Valdivia, Juan Manuel; González-Bernal, Cesáreo; Valtierra-Santiago, C I; Garnica-Garcia, Esperanza; Löfqvist, Chatarina; Hellström, Ann

doi:10.1001/archophthalmol.2012.215

Cited by 77 publications

(76 citation statements)

References 20 publications

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“…The other factor contributing to the different WinROP outcomes may lie in differences in the quality of care for prematurely born neonates in Europe and the USA compared to countries where such care may not be so readily available. The importance of this factor is supported by the fact that in our study (as well as in the studies from Sweden or USA), practically no neonates born after GW 29 developed serious ROP that would require treatment 26,32,33,[38][39] while multiple cases requiring treatment were reported in the studies from Brazil, Mexico or China [35][36][37] . In attempts to use the WinROP system for predicting development of ROP (type 1 -3), all test characteristics decreased significantly.…”

Section: Discussionsupporting

confidence: 76%

“…So far, our results are in accordance with the results from Sweden and USA reporting 100% sensitivity (and therefore, by induction, 100% negative predictive values) (ref. 26,32,33,[38][39] ) while studies from China, Mexico, Brazil or Korea [34][35][36][37] reported sensitivity values ranging from 85% to 95%. The WinROP system correctly identified all 24 infants requiring or potentially requiring treatment (Type 1 or Type 2).…”

Section: Discussionmentioning

confidence: 99%

“…Based on the results of weekly weight increments in Swedish infants, an online system WinROP was created aiming at timely prediction of a high risk of serious ROP development 25,32,33 . Several studies that evaluated ROP in different populations have been published with varying results 23,25,26,[32][33][34][35][36][37][38][39] . In this paper, we would like to contribute to this discussion by presenting an evaluation of the WinROP system based on data acquired at our department.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants

Timkovič¹,

Pokrývková²,

Janurová³

et al. 2017

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims. Retinopathy of Prematurity (ROP) is a potentially serious condition that can afflict preterm infants. Timely and correct identification of individuals at risk of developing a serious form of ROP is therefore of paramount importance. WinROP is an online system for predicting ROP based on birth weight and weight increments. However, the results vary significantly for various populations. It has not been evaluated in the Czech population. This study evaluates the test characteristics (specificity, sensitivity, positive and negative predictive values) of the WinROP system in Czech preterm infants. Methods. Data on 445 prematurely born infants included in the ROP screening program at the University Hospital Ostrava, Czech Republic, were retrospectively entered into the WinROP system and the outcomes of the WinROP and regular screening were compared. Results. All 24 infants who developed high-risk (Type 1 or Type 2) ROP were correctly identified by the system. The sensitivity and negative predictive values for this group were 100%. However, the specificity and positive predictive values were substantially lower, resulting in a large number of false positives. Extending the analysis to low risk ROP, the system did not provide such reliable results. Conclusions. The system is a valuable tool for identifying infants who are not likely to develop high-risk ROP and this could help to substantially reduce the number of preterm infants in need of regular ROP screening. It is not suitable for predicting the development of less serious forms of ROP which is however in accordance with the declared aims of the WinROP system.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants

Timkovič¹,

Pokrývková²,

Janurová³

et al. 2017

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…A web‐based prediction tool–weight, insulin‐like growth factor 1, neonatal, retinopathy of prematurity (WINROP) – based on weight development, predicts ROP needing treatment with high sensitivity in settings with highly developed neonatal care 7, 8, but with lower sensitivity in settings with poor oxygen control 9.…”

Section: Introductionmentioning

confidence: 99%

Implementing higher oxygen saturation targets reduced the impact of poor weight gain as a predictor for retinopathy of prematurity

et al. 2017

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AimThis study evaluated poor weight gain as a risk factor for infants who required treatment for retinopathy of prematurity (ROP), by comparing those born before and after the implementation of higher oxygen saturation (SpO2) targets at the Queen Silvia Children's Hospital, Gothenburg, Sweden.MethodsWe compared infants born at less than 31 weeks, who were screened and, or, treated for ROP: 127 in 2011–2012 when SpO2 targets were 88–92% and 142 in 2015–2016 when they were 91–95%. The subjects were reviewed for birth characteristics, weekly weight and ROP treatment. Data were analysed using the weight, insulin‐like growth factor 1, neonatal, ROP (WINROP) prediction tool.ResultsThe 2011–2012 infants who needed ROP treatment (12.6%) had significantly poorer postnatal weight gain than those who did not, but this was not seen in the treated (17.6%) and nontreated ROP groups in 2015–2016. WINROP sensitivity decreased from 87.5% in 2011–12 to 48% in 2015–2016.ConclusionAfter the SpO2 target range was increased from 88–92% to 91–95%, postnatal weight gain was no longer a significant risk factor and WINROP lost its ability to predict ROP requiring treatment. Risk factors clearly change as neonatal care develops.

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“…Its variable specificity and poor positive predictive value in studies (table) 98,100,[121][122][123][124][125][126] suggest that the algorithm should be used in addition to conventional screening guidelines. WINROP does not currently include infants with a gestational age at birth of more than 32 weeks.…”

Section: Classification and Screeningmentioning

confidence: 99%

Retinopathy of Prematurity

Stahl¹,

Hellström²,

Smith³

2016

Anti-Angiogenic Therapy in Ophthalmology

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The immature retinas of preterm newborns are susceptible to insults that disrupt neurovascular growth, which leads to retinopathy of prematurity. Suppression of growth factors due to hyperoxia and loss of the maternal-fetal interaction result in an arrest of retinal vascularisation (phase 1). Subsequently, the increasingly metabolically active, yet poorly vascularised, retina becomes hypoxic, stimulating growth factor-induced vasoproliferation (phase 2), which can cause retinal detachment. In very premature infants, controlled oxygen administration reduces but does not eliminate retinopathy of prematurity. Identification and control of factors that contribute to development of retinopathy of prematurity is essential to prevent progression to severe sightthreatening disease and to limit comorbidities with which the disease shares modifiable risk factors. Strategies to prevent retinopathy of prematurity will depend on optimisation of oxygen saturation, nutrition, and normalisation of concentrations of essential factors such as insulin-like growth factor 1 and ω-3 polyunsaturated fatty acids, as well as curbing of the effects of infection and inflammation to promote normal growth and limit suppression of neurovascular development.

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Prediction of Retinopathy of Prematurity Using the Screening Algorithm WINROP in a Mexican Population of Preterm Infants

Cited by 77 publications

References 20 publications

Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants

Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants

Implementing higher oxygen saturation targets reduced the impact of poor weight gain as a predictor for retinopathy of prematurity

Retinopathy of Prematurity

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