The Use of the WINROP Screening Algorithm for the Prediction of Retinopathy of Prematurity in a Chinese Population

Abstract

Background: Retinopathy of prematurity (ROP) is a gestational age (GA)-related illness that can lead to blindness in premature infants. Timely screening of premature infants could improve visual prognosis. Objective: To evaluate the WINROP algorithm as a method of predicting severe ROP in a Chinese population. Methods: 590 infants with a GA <32 weeks wereentered into an online surveillance system (www.winrop.com) that included ROP evaluations and weekly weight measurements from birth to a corrected GA of 40 weeks. If the rate of weight gain decreased to a certain degree, the algorithm signaled an alarm that the infant was at risk for developing sight-threatening ROP. Each infant was categorized as having no, mild, or severe ROP. Results: Among the 590 infants with a GA <32 weeks, an alarm was triggered in 85 infants (14.4%), 50 of which developed severe ROP and were identified in this alarm group. Twenty-seven infants triggered the alarm signal in the first week after birth and 7 infants triggered the alarm at birth. Seven of the infants developed proliferative ROP and the median GA at birth for these infants was 31 weeks. Conclusions: The WINROP system had a sensitivity of 87.5% in a Chinese population for the early identification of infants that developed severe ROP. Postnatal weight gain may help predict ROP in lower birth weight infants.

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

“…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.…”

“…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).…”

“…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.…”

Postnatal serum insulin-like growth factor i and retinopathy of prematurity

“…16 and with studies of postnatal weight gain as a predictor of the development of severe ROP. [18][19][20][21][22][23][24][25][26][27][28][29] The generalizability to a diverse U.S. cohort lends support to clinical applications, including exogenous postnatal IGF-1 supplementation, which may prevent or reduce the severity of ROP, and risk prediction, particularly through the use of a more easily obtained surrogate measure such as postnatal weight gain.…”

“…16 Slow postnatal weight gain, an assumed surrogate measure for serum IGF-1, has also been found to be predictive of severe ROP in European, North American, South American, and Asian cohorts. [18][19][20][21][22][23][24][25][26][27][28][29] Interestingly, there is increasing evidence that ethnicity may be an independent risk factor for the development of severe ROP. [30][31][32][33] However, no North American studies on IGF-1 and ROP have been reported to our knowledge.…”