WINROP algorithm for prediction of sight threatening retinopathy of prematurity: Initial experience in Indian preterm infants

Abstract

Purpose:To determine the efficacy of the online monitoring tool, WINROP (https://winrop.com/) in detecting sight-threatening type 1 retinopathy of prematurity (ROP) in Indian preterm infants.Methods:Birth weight, gestational age, and weekly weight measurements of seventy preterm infants (<32 weeks gestation) born between June 2014 and August 2016 were entered into WINROP algorithm. Based on weekly weight gain, WINROP algorithm signaled an alarm to indicate that the infant is at risk for sight-threatening Type 1 ROP. ROP screening was done according to standard guidelines. The negative and positive predictive values were calculated using the sensitivity, specificity, and prevalence of ROP type 1 for the study group. 95% confidence interval (CI) was calculated.Results:Of the seventy infants enrolled in the study, 31 (44.28%) developed Type 1 ROP. WINROP alarm was signaled in 74.28% (52/70) of all infants and 90.32% (28/31) of infants treated for Type 1 ROP. The specificity was 38.46% (15/39). The positive predictive value was 53.84% (95% CI: 39.59–67.53) and negative predictive value was 83.3% (95% CI: 57.73–95.59).Conclusion:This is the first study from India using a weight gain-based algorithm for prediction of ROP. Overall sensitivity of WINROP algorithm in detecting Type 1 ROP was 90.32%. The overall specificity was 38.46%. Population-specific tweaking of algorithm may improve the result and practical utility for ophthalmologists and neonatologists.

Prediction of retinopathy of prematurity using the screening algorithm WINROP in a Saudi cohort of preterm infants

“…This is what distinguishes our study from those conducted in other developing countries that showed lower sensitivity ranging from 80 to 90%. 12 , 14 - 16 , 20 , 24 - 27 Sensitivity has also been demonstrated to be lower in heavier infants (>1000 grams) in developed countries, which was not the case in our series. 14 …”

“…Large variations in WINROP specificity have been reported in cross-sectional studies that validated the WINROP. 8 , 10 - 12 , 14 Variability in cases, neonatal care, survival rates, and screening practices could all account for those discrepancies. However, since preventing retinal detachment and, ultimately, blindness is the goal of ROP screening, the sensitivity and NPV of ROP screening examinations are thought to be more relevant than its specificity.…”

“…The WINROP surveillance system has been validated in several studies. 8 - 12 In highly developed countries (Sweden and United States), 5 , 13 the accuracy of the test was higher, as opposed to that in less and moderately developed countries (Taiwan, Turkey, Korea). 14 - 16 This study aims to retrospectively validate the diagnostic accuracy of the readily available online WINROP algorithm in the detection of vision-threatening type 1 ROP in a cohort of premature infants from Jeddah, Saudi Arabia.…”

<p>Efficacy of WINROP as a Screening Tool for Retinopathy of Prematurity in the East Coast of Malaysia</p>

“…Table 4 summarizes the results of 12 countries of both high-and moderate-/low-income status who have participated in the WINROP study, including our study. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Overall, WINROP has been reported to have good efficacy as a screening tool. However, the sensitivity of WINROP varies among countries.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] In Asia, it has been reported in China, Korea, Taiwan, India and Japan. 6,7,11,15,16 Based on a PubMed search, no similar reports are available from the South East Asia region, especially in a developing country. This study thus aims to investigate the efficacy of WINROP in the East Coast of Malaysia.…”