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

Abstract

Purpose: To evaluate the efficacy of the "weight, insulin-like growth factor 1, neonatal retinopathy of prematurity" (WINROP) algorithm in predicting retinopathy of prematurity (ROP) requiring treatment in Malaysia. Participants: This was a retrospective study involving premature infants with gestational age less than 32 weeks treated from September 2016 to March 2019 in Hospital Universiti Sains Malaysia. Clinical diagnosis was made based on Early Treatment Retinopathy of Prematurity study. Participants' weekly weight gain since birth was entered in the website (http://winrop.com), along with date of birth, gestational age and final clinical examination outcome. WINROP software signals an alarm if an infant is at high risk of developing ROP requiring treatment during weight data entry. By using the alarm status, the sensitivity and specificity of this algorithm for predicting ROP requiring treatment were obtained. Results: Ninety-two infants were included in this study. An alarm was detected in 67 infants (72.8%). There were a total of 53 infants (54.6%) with no ROP, 15 (16.3%) of whom developed stage 1 ROP, 10 (10.8%) who developed stage 2 ROP and 14 infants (15.2%) who developed stage 3 ROP. In our study, WINROP sensitivity was 95.2% and specificity was 33.8%. Conclusion: WINROP is recommended as an initial screening tool for premature infants at risk of developing treatment-requiring ROP in Malaysia. It may help to alert clinicians managing severely ill infants when clinical examinations are less possible.

The Use of Postnatal Weight Gain Algorithms to Predict Severe or Type 1 Retinopathy of Prematurity

“…The full text was read for eligibility, of which 61 were included in the final analysis. The 61 studies (>37 000 infants) included WINROP (n = 36), 6 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 G-ROP (n = 9), 7 , 42 , 56 , 57 , 58 , 59 , 60 , 61 PINT ROP (n = 1), 8 CHOP ROP (n = 6), 9 , 30 , 55 , 62 , 63 , 64 ROPScore (n = 5), 10 , 30 , 55 , 65 , 66 and CO-ROP (n = 4). 11 , 67 , 68 , …”

“…This could have been the explanation for the low sensitivity in low- to middle-income countries, where there is uneven practice with regard to oxygen targeting in preterm infants. 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 …”

Haemoglobin Levels in Early Life among Infants with and without Retinopathy of Prematurity

“…As haemoglobin levels are lower in more premature infants as well as those with lower birth weight [ 57 ], failure to account for these may confound results. Other strengths of our study are its close evaluation of serial weekly mean haemoglobin levels during the critical period of ROP development, and adjustment for multiple confounders [ 58 ]. The present study is limited by the nature of its retrospective design.…”

“…Future directions for research may include the use of other haematological indices to allow earlier detection and treatment of this sight-threatening disease [ 31 ]. Besides this, the incorporation of haemoglobin levels into software algorithms, such as WINROP, which automatically alerts the clinician in cases of increased ROP risk, may also be beneficial [ 58 , 59 , 60 ]. These strategies may permit more efficient and cost-effective ROP screening, which could improve visual outcomes among premature infants.…”

Risk factors for retinopathy of prematurity: a current literature review

“…The determined parameters allow the estimation of the IGF-1 level, which in turn enables the prediction of the risk factor for the development of ROP. The algorithm has been found to be particularly useful in predicting stage 1 ROP [16][17][18]. Recent studies indicate that WINROP needs additional revisions that would complement the existing screening criteria.…”