Colorado retinopathy of prematurity model: a multi-institutional validation study

Cao, Jennifer H.; Wagner, Brandie D.; Cerda, Ashlee M.; McCourt, Emily A.; Palestine, Alan G.; Enzenauer, Robert W.; Braverman, Rebecca; Wong, Ryan; Tsui, Irena; Gore, Charlotte; Robbins, Shira L.; Puente, Michael A.; Kauffman, Levi; Kong, Lingkun; Morrison, David G.; Lynch, Anne M.

doi:10.1016/j.jaapos.2016.01.017

Cited by 34 publications

(38 citation statements)

References 21 publications

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“…12,13 3. Authors of recent reports of neonatal algorithms, such as WIN-ROP, 16 Co-ROP, 17 and CHOP-ROP, 18 take factors into account other than birth weight, postmenstrual age, or gestational age. These factors include rapid postnatal weight gain and may be helpful in selecting infants at risk for ROP who should be screened and in eliminating some infants from the need for screening despite their meeting the previously mentioned screening criteria.…”

Section: Introductionmentioning

confidence: 99%

Screening Examination of Premature Infants for Retinopathy of Prematurity

Fierson¹,

Chiang²,

Good³

et al. 2018

Pediatrics

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692

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This policy statement revises a previous statement on screening of preterm infants for retinopathy of prematurity (ROP) that was published in 2013. ROP is a pathologic process that occurs in immature retinal tissue and can progress to a tractional retinal detachment, which may then result in visual loss or blindness. For more than 3 decades, treatment of severe ROP that markedly decreases the incidence of this poor visual outcome has been available. However, severe, treatment-requiring ROP must be diagnosed in a timely fashion to be treated effectively. The sequential nature of ROP requires that infants who are at-risk and preterm be examined at proper times and intervals to detect the changes of ROP before they become destructive. This statement presents the attributes of an effective program to detect and treat ROP, including the timing of initial and follow-up examinations.

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Section: Introductionmentioning

confidence: 99%

Screening Examination of Premature Infants for Retinopathy of Prematurity

Fierson¹,

Chiang²,

Good³

et al. 2018

Pediatrics

Self Cite

692

241

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“…In postnatal phase 2, relative local hypoxia promotes increased Hif1α and VEGF, fueling pathologic blood vessel proliferation 2 . Moreover, postnatal weight gain, as a surrogate of insulin growth factor 1 (IGF-1) levels and protective against ROP, has been suggested as an additional screening filter in an effort to reduce unnecessary eye exams 3 . However, it is possible that there is an even earlier “phase” of ROP development which occurs in utero, such that an abnormal prenatal environment may modulate risk for postnatal development of ROP.…”

Section: Introductionmentioning

confidence: 99%

Prenatal intrauterine growth restriction and risk of retinopathy of prematurity

Chu

Dhindsa

Sim

et al. 2020

Sci Rep

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Low birthweight and decreased postnatal weight gain are known predictors of worse retinopathy of prematurity (ROP) but the role of prenatal growth patterns in ROP remains inconclusive. To distinguish small for gestational age (SGA) from intrauterine growth restriction (IUGR) as independent predictors of ROP, we performed a retrospective cohort study of patients who received ROP screening examinations at a level IV neonatal intensive care unit over a 7-year period. Data on IUGR and SGA status, worst stage of and need for treatment for ROP, and postnatal growth was obtained. 343 infants were included for analysis (mean gestational age = 28.6 weeks and birth weight = 1138.2 g). IUGR infants were more likely to have a worse stage of ROP and treatment-requiring ROP (both p < 0.0001) compared to non-IUGR infants. IUGR infants were more likely to be older at worst stage of ROP (p < 0.0001) and to develop postnatal growth failure (p = 0.01) than non-IUGR infants. Independent of postnatal growth failure status, IUGR infants had a 4–5 × increased risk of needing ROP treatment (p < 0.001) compared to non-IUGR infants. SGA versus appropriate for gestational age infants did not demonstrate differences in retinopathy outcomes, age at worst ROP stage, or postnatal growth failure. These findings emphasize the importance of prenatal growth on ROP development.

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“…Efforts to address workload by narrowing screening guidelines, for example, by narrowing the catchment window to infants below 29 or 30 weeks of gestation, may cause some infants requiring treatment to be missed, with attendant personal and societal costs of otherwise preventable blindness. Screening algorithms such as those from Colorado and WINROP [6][7][8] add clinical data on a baby to enhance AAP guidelines in an attempt to decrease the number of babies screened. Such studies suffer from study [17].…”

Section: Discussionmentioning

confidence: 99%

“…Modifying the American Academy of Pediatrics ROP guidelines [2] to exclude from screening lower-risk infants could reduce the ROP workload. This approach focuses on excluding infants at higher gestational ages with low clinical risk factors [3][4][5][6][7][8][9]. Alternatively, telemedicine (using store and forward retinal images) reduces the frequency of on-site ophthalmologist examinations, with only those babies approaching threshold ROP transferred to a referral facility [10].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with retinopathy of prematurity ophthalmology workload

Jacob

Matrix²,

Skopec

et al. 2018

J Perinatol

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ObjectiveThis article reports on retinopathy of prematurity (ROP) workload in the NICU related to severity of disease, gestational age at discharge, and practice variation.Study designData analysis on 1771 patients ≤ 30 weeks of gestation at birth from a de-identified data set of 13 NICUs.ResultsThere was a positive relationship between the severity of ROP and (1) the number of exams per patient, (2) the severity of ROP, and (3) postmenstrual age at discharge. The progression between the stages of ROP added to exam workload and postmenstrual age at NICU discharge. The addition of plus disease did not increase the exam burden. There was significant practice variation in the number of exams performed independent of ROP severity.ConclusionThe progression of the severity of ROP independent of plus disease, and practice variations both contribute to ROP workload. Addressing these factors could decrease ROP workload without compromising American Academy of Pediatrics (AAP) guidelines.

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Colorado retinopathy of prematurity model: a multi-institutional validation study

Cited by 34 publications

References 21 publications

Screening Examination of Premature Infants for Retinopathy of Prematurity

Screening Examination of Premature Infants for Retinopathy of Prematurity

Prenatal intrauterine growth restriction and risk of retinopathy of prematurity

Factors associated with retinopathy of prematurity ophthalmology workload

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