Validation of the Postnatal Growth and Retinopathy of Prematurity (G-ROP) screening criteria

Abstract

Background: Retinopathy of prematurity (ROP) is a leading cause of irreversible blindness in infants. The Postnatal Growth and ROP (G-ROP) study proposed new screening criteria for ROP. This study aimed to validate the G-ROP screening criteria in a group of Iranian premature infants who were treated in the neonatal intensive care unit (NICU) for at least 40 days.
 Methods: In this retrospective study, we extracted the data pertaining to infants admitted to the NICU from January 2020 to December 2021. We screened all the included infants for ROP based on the Iranian national screening criteria. We applied the G-ROP criteria to our study population, and if no criterion was met, the infant was exempted from ROP screening. We determined the sensitivity and specificity of the G-ROP guidelines for ROP detection, along with its capacity for predicting the requirement for ROP treatment. Moreover, we compared the G-ROP guidelines with the Iranian and North American guidelines for ROP screening.
 Results: A total of 166 premature infants with complete datasets were included: 130 had ROP, of whom 61 were treated. There were 109 female infants (65.7%). The mean (standard deviation [SD]) birth weight and gestational age were 1080 (256) g and 28.28 (1.97) weeks, respectively. Applying the G-ROP criteria, 127 of 130 infants with ROP were identified (sensitivity, 97.69%; 95% confidence interval [CI], 95.11% – 100%), and of 36 infants without ROP, three were correctly excluded (specificity, 8.33%; 95% CI, 0% – 17.36%). The G-ROP criteria did not fail to identify infants who required treatment for ROP (sensitivity, 100%; 95% CI, 98.29 – 100) and had a specificity of 8.69% (95% CI, 2.04% – 15.34%). Although the Iranian and North American criteria had 100% sensitivity for infants with any stage of ROP, they could not detect infants without ROP (0% specificity).
 Conclusions: The G-ROP screening criteria had a sensitivity of 100% in identifying infants requiring treatment for ROP in our high-risk group; however, specificity was not sufficiently high. Further studies with larger numbers of referred infants could confirm a decrease in the burden of retinal examinations using these criteria.

Retrospective cohort evaluation of postnatal growth and retinopathy of prematurity (G‐ROP) criteria in a tertiary centre in Turkey

“…On the other hand, studies from socio-economically developing countries, such as Egypt, Iran, Thai, and another study from Turkey, reported the sensitivity for treated and Type 1 ROP was 100%, similar to ours (Ahmed et al, 2022;Fadakar et al, 2022;Okbay Gunes et al, 2022;Trinavarat et al, 2023) (Table 2). Furthermore, in a study from China, three severe ROP cases missed by GA and BW criteria were detected by the WG criterion (Lu et al, 2023).…”

“…(2018). A sensitivity rate of 100% for Type 1 ROP or for treated ROP was also achieved in different populations such as the UK, Egypt, Switzerland, Japan, the USA, Iran, Thai, Turkey, and Italy (Ahmed et al., 2022; Caruggi et al., 2021; Fadakar et al., 2022; Okbay Gunes et al., 2022; Shiraki et al., 2019; Trinavarat et al., 2023; Vinayahalingam et al., 2022; Wadley et al., 2020) (Table 2).…”

Validation of postnatal growth and retinopathy of prematurity (G-ROP) screening guidelines in a tertiary care hospital of Pakistan: A report from low-middle income country

“…In a similar study by Fadakar et al from Iran, it was shown that G-ROP screening criteria can achieve a sensitivity of 97.6%, and of 36 infants without ROP, whereas 3 infants were correctly excluded (specificity = 8.3%). The G-ROP criteria did not fail to identify infants who required treatment for ROP (sensitivity, 100%) and had a specificity of 8.69% [ 1 ]. A similar study from Egypt applied the G-ROP model to 605 premature infants and reported 100% sensitivity with a median GA of 31.5 wk and median BW of 1200 gm.…”

“…Retinopathy of prematurity (ROP) is one of the leading causes of preventable loss of vision in premature babies worldwide and disproportionately affects premature babies in low- and middle-income countries (LMICs) like Pakistan [ 1 ]. Improved neonatal care in LMICs has undeniably led to a rise in the survival rates of preterm and low birth weight infants [ 2 , 3 ].…”

Retinal blood flow association with age and weight in infants at risk for retinopathy of prematurity

“…Although BW and GA are quite important in terms of ROP risk, we observed an absence of association with blood flow. This may be explained by the previous literature that indicates some contribution to ROP risk is also related to post-natal growth 35 . In terms of GA, we found that the chronological age has a stronger association with blood flow.…”