Prediction of retinopathy of prematurity using the screening algorithm WINROP in a Mexican population of preterm infants.

Archives of ophthalmology (Impact Factor: 4.49). 06/2012; 130(6):720-3. DOI: 10.1001/archophthalmol.2012.215
Source: PubMed

ABSTRACT To retrospectively validate the WINROP (weight, insulin-like growth factor I, neonatal, retinopathy of prematurity [ROP]) algorithm in identification of type 1 ROP in a Mexican population of preterm infants.
In infants admitted to the neonatal intensive care unit at Hospital Civil de Guadalajara from 2005 to 2010, weight measurements had been recorded once weekly for 192 very preterm infants (gestational age [GA] <32 weeks) and for 160 moderately preterm infants (GA ≥32 weeks). Repeated eye examinations had been performed and maximal ROP stage had been recorded. Data are part of a case-control database for severe ROP risk factors.
Type 1 ROP was found in 51.0% of very preterm and 35.6% of moderately preterm infants. The WINROP algorithm correctly identified type 1 ROP in 84.7% of very preterm infants but in only 5.3% of moderately preterm infants. For infants with GA less than 32 weeks, the specificity was 26.6%, and for those with GA 32 weeks or more, it was 88.3%.
In this Mexican population of preterm infants, WINROP detected type 1 ROP early in 84.7% of very preterm infants and correctly identified 26.6% of infants who did not develop type 1 ROP. Uncertainties in dating of pregnancies and differences in postnatal conditions may be factors explaining the different outcomes of WINROP in this population.

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    ABSTRACT: The immature retinas of preterm neonates are susceptible to insults that disrupt neurovascular growth, leading to retinopathy of prematurity. Suppression of growth factors due to hyperoxia and loss of the maternal-fetal interaction result in an arrest of retinal vascularisation (phase 1). Subsequently, the increasingly metabolically active, yet poorly vascularised, retina becomes hypoxic, stimulating growth factor-induced vasoproliferation (phase 2), which can cause retinal detachment. In very premature infants, controlled oxygen administration reduces but does not eliminate retinopathy of prematurity. Identification and control of factors that contribute to development of retinopathy of prematurity is essential to prevent progression to severe sight-threatening disease and to limit comorbidities with which the disease shares modifiable risk factors. Strategies to prevent retinopathy of prematurity will depend on optimisation of oxygen saturation, nutrition, and normalisation of concentrations of essential factors such as insulin-like growth factor 1 and ω-3 polyunsaturated fatty acids, as well as curbing of the effects of infection and inflammation to promote normal growth and limit suppression of neurovascular development.
    The Lancet 06/2013; DOI:10.1016/S0140-6736(13)60178-6 · 39.21 Impact Factor
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    ABSTRACT: Background: Retinopathy of prematurity (ROP) is a gestational age (GA)-related illness that can lead to blindness in premature infants. Timely screening of premature infants could improve visual prognosis. Objective: To evaluate the WINROP algorithm as a method of predicting severe ROP in a Chinese population. Methods: 590 infants with a GA <32 weeks were entered into an online surveillance system ( that included ROP evaluations and weekly weight measurements from birth to a corrected GA of 40 weeks. If the rate of weight gain decreased to a certain degree, the algorithm signaled an alarm that the infant was at risk for developing sight-threatening ROP. Each infant was categorized as having no, mild, or severe ROP. Results: Among the 590 infants with a GA <32 weeks, an alarm was triggered in 85 infants (14.4%), 50 of which developed severe ROP and were identified in this alarm group. Twenty-seven infants triggered the alarm signal in the first week after birth and 7 infants triggered the alarm at birth. Seven of the infants developed proliferative ROP and the median GA at birth for these infants was 31 weeks. Conclusions: The WINROP system had a sensitivity of 87.5% in a Chinese population for the early identification of infants that developed severe ROP. Postnatal weight gain may help predict ROP in lower birth weight infants.
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    ABSTRACT: This study validates the newly developed WINROP algorithm aimed at detecting retinopathy of prematurity (ROP) requiring treatment at an early stage. The study was conducted at two middle-sized hospitals in Sweden, prospectively and retrospectively. A total of 104 children participated in this study. Their mean gestational age at birth was 28.7 weeks (range, 23.6-32.1 weeks), and their mean birth weight was 1208 g (range, 477-2340 g). Weekly weight measurements were used in WINROP to calculate the risk of developing ROP. 80% of infants (83/104) had no ROP, 15% (16/104) had mild ROP (stage 1 or 2), 5% (5/104) had severe ROP, and 2% (2/104) were treated for ROP. The alarm was registered at an average of 2 weeks postnatal age (range 1-6 weeks). WINROP identified all the infants at risk for developing stage 3 ROP (100% sensitivity) and had a 59% specificity. The alarm was registered several weeks before screening for ROP began. WINROP can be used to complement conventional ROP screening.
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