The International Classification of Retinopathy of Prematurity Revisited

Gole, Glen A.; Ells, Anna L.; Katz, Ximena; Holmström, Gerd; Fielder, A R; Capone, Antonio; Flynn, John T.; Good, William G.; Holmes, J. M.; McNamara, J. Arch; Palmer, Earl A.; Quinn, Graham E.; Shapiro, Michael J.; Trese, Matthew G.J.; Wallace, David K.

doi:10.1001/archopht.123.7.991

Cited by 2,354 publications

(723 citation statements)

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“…In the 2011–2012, cohort two infants who were treated for ROP were not identified by WINROP. One of these infants had severe ROP, but did not fulfil the established ROP treatment criteria 12. In the 2015–2016 cohort, all of the 25 infants had fulfilled the established ROP treatment criteria, but just over half of these infants (n‐13) were not identified by WINROP.…”

Section: Resultsmentioning

confidence: 99%

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Implementing higher oxygen saturation targets reduced the impact of poor weight gain as a predictor for retinopathy of prematurity

et al. 2017

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AimThis study evaluated poor weight gain as a risk factor for infants who required treatment for retinopathy of prematurity (ROP), by comparing those born before and after the implementation of higher oxygen saturation (SpO2) targets at the Queen Silvia Children's Hospital, Gothenburg, Sweden.MethodsWe compared infants born at less than 31 weeks, who were screened and, or, treated for ROP: 127 in 2011–2012 when SpO2 targets were 88–92% and 142 in 2015–2016 when they were 91–95%. The subjects were reviewed for birth characteristics, weekly weight and ROP treatment. Data were analysed using the weight, insulin‐like growth factor 1, neonatal, ROP (WINROP) prediction tool.ResultsThe 2011–2012 infants who needed ROP treatment (12.6%) had significantly poorer postnatal weight gain than those who did not, but this was not seen in the treated (17.6%) and nontreated ROP groups in 2015–2016. WINROP sensitivity decreased from 87.5% in 2011–12 to 48% in 2015–2016.ConclusionAfter the SpO2 target range was increased from 88–92% to 91–95%, postnatal weight gain was no longer a significant risk factor and WINROP lost its ability to predict ROP requiring treatment. Risk factors clearly change as neonatal care develops.

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Section: Resultsmentioning

confidence: 99%

“…The International Classification of Retinopathy of Prematurity was used 12: stages one and two were defined as mild ROP, and stages three to five were defined as severe ROP. Treatments were based on the recommendations of the Early Treatment for Retinopathy of Prematurity Cooperative Group 13.…”

Section: Methodsmentioning

confidence: 99%

Implementing higher oxygen saturation targets reduced the impact of poor weight gain as a predictor for retinopathy of prematurity

et al. 2017

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“…Poor generalisability limits their use. [15,17] Another tool has been developed by Binenbaum, [17] which can also be used in more mature infants at risk for ROP in countries with developing neonatal care systems (personal communication, Prof. C Gilbert, 10 February 2016).…”

Section: Discussionmentioning

confidence: 99%

“…ROP screening activities at TCH commenced before the release of national screening criteria and were governed by local data and resources at the time. Infants were examined and staged according to the International Classification of ROP (2005 revision) [15] by a trained ophthalmologist using a 28-dioptre condensing lens and an indirect ophthalmoscope. The screening team consisted of one technician and three doctors (the supervising paediatric ophthalmologist and two registrars in training).…”

Section: Methodsmentioning

confidence: 99%

Retinopathy of prematurity screening criteria and workload implications at Tygerberg Children’s Hospital, South Africa: A cross-sectional study

et al. 2016

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Background. Screening guidelines for retinopathy of prematurity (ROP) used in high-income countries are not appropriate for middleincome countries, and screening requirements may vary even between units within one city. Objective. To determine optimal ROP screening criteria, and its workload implications, for Tygerberg Children's Hospital (TCH), Cape Town, South Africa. Methods. This cross-sectional study included premature infants screened for ROP at TCH from 1 January 2009 to 31 December 2014. Logistic regression analysis for prediction and classification was performed. Predictors were birth weight (BW) and gestational age (GA). Endpoints were clinically significant ROP (CSROP) and type 1 ROP (T1ROP). Results. Of 1 104 eligible infants, 33.4% had ROP (CSROP 9.1%, T1ROP 2.5%). All T1ROP infants received laser therapy. The number of screening examinations was inversely correlated with GA and BW. The number needed to screen to identify one infant requiring treatment was 41 (entailing 83 examinations, 4 screening hours, one technician and three doctors). Screening infants with a GA of ≤28 weeks or a BW of <1 000 g would have detected all infants with T1ROP but missed two outliers with CSROP. These outliers would only have been detected with a GA of ≤32 weeks or a BW <1 500 g. Conclusions. Detection of infants with T1ROP is resource intensive. Larger infants require screening to include a few outliers, but they require fewer examinations than smaller infants. Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

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“…[5] ROP is classified according to the International Classification of ROP (ICROP), was standardised in 1984, and updated in 1987 and again in 2005. [12] ROP is characterised by using four components (Table 1): (i) location (zones 1 -3); (ii) severity (stages 1 -5); (iii) extent (circumferential location of the disease reported as clock hours); and (iv) plus disease (tortuosity of posterior retinal vessels). [7] Two important definitions are those of threshold ROP and prethreshold ROP ( Table 2).…”

Section: Researchmentioning

confidence: 99%

An evaluation of the screening for retinopathy of prematurity in very-low-birth-weight babies at a tertiary hospital in Johannesburg, South Africa

Dadoo

Ballot

2016

S Afr J CH

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Background. Retinopathy of prematurity (ROP) is a leading cause of blindness for very-low-birth-weight (VLBW, <1 500 g) babies. ROP screening identifies babies that require treatment to prevent major visual impairment. Objectives. To evaluate the screening for ROP at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) by reviewing the number of babies screened according to the CMJAH guidelines, the grades of ROP found and the treatment modality received. Methods. This was a retrospective record review of VLBW babies born between 1 January 2013 and 31 December 2013 at CMJAH, whether inborn or transferred in. The babies were divided into two groups based on age at final outcome. Final outcome was defined as death, discharge or transfer out of the unit. The 'early' outcome group had their final outcome before day 28 of life. The 'late' outcome group had their final outcome at day 28 or more of life. The early outcome group qualified for outpatient ROP screening and the late outcome group qualified for inpatient ROP screening.Results. There were a total of 572 VLBW babies at CMJAH during this time period. The babies had a mean birth weight of 1 127 (standard deviation (SD) 244.75) g and gestational age of 29 (2.743) weeks. The mean duration of stay was 29 (21.66) days and there were 309 female babies. Of these 572 babies, 304 comprised the early outcome group and 268 comprised the late outcome group. In the early outcome group babies who were transferred out of the unit or died were excluded; therefore the remaining 147 babies discharged home qualified for outpatient ROP screening. Inpatient ROP screening was carried out in 36/147 (24.4%) of these babies (not in accordance with ROP screening guidelines). ROP was documented in 4/36 (11.1%). Outpatient ROP screening records were unavailable. Exclusions from the late outcome group included five babies. In the late outcome group 111/263 (42.2%) were screened for ROP. ROP was found in 17%. One baby required treatment with intravitreal antivascular endothelial growth factor (VEGF) and three babies required surgery. Conclusions. More than half of the babies in the late outcome group were not screened during their stay (57.8%). More than one-third of babies were discharged prior to reaching the current recommended age for screening. Efforts need to be intensified to identify and screen all eligible babies prior to discharge. Outpatient ROP screening is not well documented; therefore prevalence cannot be established.

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The International Classification of Retinopathy of Prematurity Revisited

Cited by 2,354 publications

References 1 publication

Implementing higher oxygen saturation targets reduced the impact of poor weight gain as a predictor for retinopathy of prematurity

Implementing higher oxygen saturation targets reduced the impact of poor weight gain as a predictor for retinopathy of prematurity

Retinopathy of prematurity screening criteria and workload implications at Tygerberg Children’s Hospital, South Africa: A cross-sectional study

An evaluation of the screening for retinopathy of prematurity in very-low-birth-weight babies at a tertiary hospital in Johannesburg, South Africa

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