A predictive score for retinopathy of prematurity in very low birth weight preterm infants

Abstract

Aims This study describes the development of a score based on cumulative risk factors for the prediction of severe retinopathy of prematurity (ROP) comparing the performance of the score against the birth weight (BW) and gestational age (GA) in order to predict the onset of ROP. Methods A prospective cohort of preterm infants with BWp1500 g and/or GAp32 weeks was studied. The score was developed based on BW, GA, proportional weight gain from birth to the 6th week of life, use of oxygen in mechanical ventilation, and need for blood transfusions from birth to the 6th week of life. The score was established after linear regression, considering the impact of each variable on the occurrences of any stage and severe ROP. Receiver operating characteristic (ROC) curves were used to determine the best sensitivity and specificity values for the score. All variables were entered into an Excel spreadsheet (Microsoft) for practical use by ophthalmologists during screening sessions. Results The sample included 474 patients. The area under the ROC curve for the score was 0.77 and 0.88 to predict any stage and severe ROP, respectively. These values were significantly higher for the score than for BW (0.71) and GA (0.69) when measured separately. Conclusions ROPScore is an excellent index of neonatal risk factors for ROP, which is easy to record and more accurate than BW and GA to predict any stage ROP or severe ROP in preterm infants. The scoring system is simple enough to be routinely used by ophthalmologists during screening examination for detection of ROP.

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.…”

The 5-minute Apgar Score as a Prognostic Factor for Development and Progression of Retinopathy of Prematurity

“…[2][3][4][5]11,20 Survival of more immature and prematurely born children leads to increasing number of patients who need regular ophthalmological screening. Early determination of high risk patients that develop ROP requiring treatment will results in having an adequate therapeutic approach to them.…”

“…The research on the various risk factors is extensive in literature. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Finding an easily applicable and noninvasive prognostic model for the expected course of ROP is a keystone in controlling this socially signifi cant disease. This will allow us to focus the limited human and fi nancial resource in Bulgaria on patients at risk.…”

Decreased postural control in adolescents born with extremely low birth weight

“…One possible explanation could be that the visual information quality is compromised by the common deficits among VLBW children and adolescents of poorer visual functions, including poorer visual acuity, stereoacuity, contrast sensitivity and more strabismus than controls (Powls et al 1997;Evensen et al 2009). Moreover, one of the common morbidities with premature birth is severe retinopathy, which to various degree may affect vision and in worst case cause blindness if not properly treated (Eckert et al 2012). However, the complex combination of deficits observed with eyes open in this study also has many similarities with those observed under severe alcohol intoxication (Modig et al 2012), i.e., conditions under which the oculomotor functions are compromised (Fransson et al 2010).…”