DIGIROP efficacy for detecting treatment-requiring retinopathy of prematurity in a Portuguese cohort

Almeida, Ana C.; Borrego, Luís Miguel; Brízido, Margarida; Figueiredo, Melissa Brigham de; Teixeira, F.; Coelho, Constança; Teixeira, Susana

doi:10.1038/s41433-021-01455-8

Cited by 3 publications

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References 24 publications

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“…Looking at the varying results we are able to note that these studies were conducted in different countries with different levels of income and on infants of different ethnicities They are summarized in Table 3 [ 12 – 30 ].…”

Section: Discussionmentioning

confidence: 99%

Validation of WINROP algorithm as screening tool of retinopathy of prematurity among Egyptian preterm neonates

Fares,

Abdelmonaim,

Sayed

et al. 2024

Eye

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Background Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness worldwide. Proper screening for ROP can prevent loss of vision. WINROP (weight, insulin-like growth factor 1, neonatal, retinopathy of prematurity) is an online surveillance system based on gestational age, birth weight and weekly weight gain that can predict infants at risk of sight-threatening retinopathy of prematurity. Aims To evaluate the diagnostic accuracy of WINROP algorithm in detecting sight-threatening ROP in Egyptian preterm neonates. Methods Birth weight (BW), gestational age (GA) and weekly weight measurement of 365 preterm infants were prospectively entered into WINROP algorithm. Based on these inputs, the algorithm would output and a screening was performed as is standard. Sensitivity, specificity, and predictive values were calculated by comparing WINROP outcomes with ROP screening outcomes. Results Of the infants included in the study the mean GA was ±31.24 and mean BW was ±1508.78. A high risk WINROP alarm was triggered in 62 infants of whom 16 infants develop type 1 or type 2 ROP. These infants had associated comorbidities including sepsis, Intraventricular hemorrhage (IVH), Necrotizing enterocolitis (NEC), history of transfusion of packed red blood cells (RBCS) and history of platelet transfusion. A low risk WINROP alarm was triggered in 303 infants of whom 15 infants developed type 1 or type 2ROP. WINROP showed a sensitivity of 51.6%, a specificity of 86.2%, a positive predictive value (PPV) of 52.8% and a negative predictive value (NPV) of 95% for detection of type 1 or type 2 ROP. Conclusion WINROP has low sensitivity and high specificity for detection of ROP. It may help in ROP prediction but can’t be used alone. Modification of WINROP algorithm taking into account other risk factors may improve sensitivity and reduce number for ROP examination.

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Section: Discussionmentioning

confidence: 99%

Validation of WINROP algorithm as screening tool of retinopathy of prematurity among Egyptian preterm neonates

Fares,

Abdelmonaim,

Sayed

et al. 2024

Eye

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The Male to Female Ratio in Treatment-Warranted Retinopathy of Prematurity

et al. 2022

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ImportanceLiterature and anecdotal evidence suggest a relationship between male sex and retinopathy of prematurity (ROP). It is not known whether a difference, if present, is sex-related pathophysiologic predisposition or sex difference in meeting ROP screening criteria.ObjectiveTo evaluate the association of sex with the development of treatment-warranted ROP.Data SourcesPubMed, Embase, and Web of Science databases were searched from 2000 to 2022. The search strategy used keywords including retinopathy of prematurity or ROP or retrolental fibroplasia and treatment or anti-VEGF or bevacizumab or ranibizumab or aflibercept or conbercept or laser or cryotherapy and gender or sex or male or female and medical subject headings terms.Study SelectionAll studies reporting on treatment with anti–vascular endothelial growth factor, laser photocoagulation, and/or cryotherapy for ROP were identified. Studies reporting sex distribution in the treatment group were included in the meta-analysis. Exclusion criteria included case reports, case series of fewer than 10 treated patients, systematic reviews, conference abstracts, letters to the editor, animal studies, and non-English records.Data Extraction and SynthesisTwo reviewers independently screened and extracted the data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The proportions of treated male and female infants were combined using random-effects meta-analysis.Main Outcomes and MeasuresNumbers and percentages of male and female infants treated for ROP.ResultsOf 11 368 identified studies, 316 met inclusion criteria, yielding a total of 31 026 treated patients. A higher percentage of male infants were treated for ROP (55% [95% CI, 0.54%-0.55%]), with low heterogeneity between studies (I2 = 34%; P &lt; .001). Thirty-eight studies reported sex distribution in the screened population (170 053 patients; 92 612 [53%] male vs 77 441 [47%] female). There was no significant difference in the odds of receiving treatment between screened male and female infants (pooled odds ratio, 1.04 [95% CI, 0.91-1.18]; P = .67).Conclusions and RelevanceMore male infants are treated for ROP than female infants. This could be due to a known relative pathophysiological fragility of preterm male infants in addition to a difference in ROP screening rates, with more male infants meeting the criteria than female infants. These findings have implications for future studies and may prompt more careful clinical monitoring of male neonates.

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Validation of DIGIROP models and decision support tool for prediction of treatment for retinopathy of prematurity on a contemporary Swedish cohort

et al. 2022

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Background/AimsRetinopathy of prematurity (ROP) is currently diagnosed through repeated eye examinations to find the low percentage of infants that fulfil treatment criteria to reduce vision loss. A prediction model for severe ROP requiring treatment that might sensitively and specifically identify infants that develop severe ROP, DIGIROP-Birth, was developed using birth characteristics. DIGIROP-Screen additionally incorporates first signs of ROP in different models over time. The aim was to validate DIGIROP-Birth, DIGIROP-Screen and their decision support tool on a contemporary Swedish cohort.MethodsData were retrieved from the Swedish national registry for ROP (2018–2019) and two Swedish regions (2020), including 1082 infants born at gestational age (GA) 24 to <31 weeks. The predictors were GA at birth, sex, standardised birth weight and age at the first sign of ROP. The outcome was ROP treatment. Sensitivity, specificity and area under the receiver operating characteristic curve (AUC) with 95% CI were described.ResultsFor DIGIROP-Birth, the AUC was 0.93 (95% CI 0.90 to 0.95); for DIGIROP-Screen, it ranged between 0.93 and 0.97. The specificity was 49.9% (95% CI 46.7 to 53.0) and the sensitivity was 96.5% (95% CI 87.9 to 99.6) for the tool applied at birth. For DIGIROP-Screen, the cumulative specificity ranged between 50.0% and 78.7%. One infant with Beckwith-Wiedemann syndrome who fulfilled criteria for ROP treatment and had no missed/incomplete examinations was incorrectly flagged as not needing screening.ConclusionsDIGIROP-Birth and DIGIROP-Screen showed high predictive ability in a contemporary Swedish cohort. At birth, 50% of the infants born at 24 to <31 weeks of gestation were predicted to have low risk of severe ROP and could potentially be released from ROP screening examinations. All routinely screened treated infants, excluding those screened for clinical indications of severe illness, were correctly flagged as needing ROP screening.

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DIGIROP efficacy for detecting treatment-requiring retinopathy of prematurity in a Portuguese cohort

Cited by 3 publications

References 24 publications

Validation of WINROP algorithm as screening tool of retinopathy of prematurity among Egyptian preterm neonates

Validation of WINROP algorithm as screening tool of retinopathy of prematurity among Egyptian preterm neonates

The Male to Female Ratio in Treatment-Warranted Retinopathy of Prematurity

Validation of DIGIROP models and decision support tool for prediction of treatment for retinopathy of prematurity on a contemporary Swedish cohort

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