Using WINROP as an Adjuvant Screening Tool for Retinopathy of Prematurity in Southern Taiwan

Abstract

Objective To study the efficacy of the WINROP (https://winrop.com) algorithm in Taiwan, a middle income, moderately developed country in Asia.

Study Design We enrolled all preterm infants born with a gestational age less than 32⁺⁰ weeks from September 2008 to August 2010. The results of serial retinopathy of prematurity examinations according to the screening guidelines in our hospital were recorded. Weekly body weight was also recorded for the WINROP algorithm. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated.

Results Overall, 148 infants were included. Seventeen infants (11.5%) received treatment for retinopathy of prematurity. But, six infants (35.3%) were missed when severe retinopathy of prematurity was predicted with WINROP algorithm. The sensitivity is only 64.7%. However, when focusing on the preterm infants with a birth weight < 1,000 g or gestational age < 28 weeks, it could predict the need for treatment up to 13 weeks in advance.

Conclusion The WINROP algorithm is a very effective noninvasive screening tool for retinopathy of prematurity, especially in preterm infants with a birth weight  < 1,000 g or a gestational age < 28 weeks. However, the overall sensitivity in this report from Taiwan was not as high as that reported in highly developed countries.

Keywords

retinopathy of prematurity - WINROP - prematurity - screening tool

• References

• 1 Muñoz B, West SK. Blindness and visual impairment in the Americas and the Caribbean. Br J Ophthalmol 2002; 86 (5) 498-504
• 2 Maida JM, Mathers K, Alley CL. Pediatric ophthalmology in the developing world. Curr Opin Ophthalmol 2008; 19 (5) 403-408
• 3 Gilbert C, Fielder A, Gordillo L , et al; International NO-ROP Group. Characteristics of infants with severe retinopathy of prematurity in countries with low, moderate, and high levels of development: implications for screening programs. Pediatrics 2005; 115 (5) e518-e525
• 4 Section on Ophthalmology American Academy of Pediatrics; American Academy of Ophthalmology; American Association for Pediatric Ophthalmology and Strabismus. Screening examination of premature infants for retinopathy of prematurity. Pediatrics 2006; 117 (2) 572-576
• 5 Wilkinson AR, Haines L, Head K, Fielder AR ; Guideline Development Group of the Royal College of Paediatrics and Child Health; Royal College of Ophthalmologists; British Association of Perinatal Medicine. UK retinopathy of prematurity guideline. Eye (Lond) 2009; 23 (11) 2137-2139
• 6 Jandeck C, Kellner U, Lorenz B, Seiberth V ; Arbeitsgruppe der Retinologischen Gesellschaft zur Erstellung der Leitlinie zur augenärztlichen Screening-Untersuchung von Frühgeborenen. [Guidelines for ophthalmological screening of premature infants in Germany]. Klin Monatsbl Augenheilkd 2008; 225 (2) 123-130
• 7 Binkhathlan AA, Almahmoud LA, Saleh MJ, Srungeri S. Retinopathy of prematurity in Saudi Arabia: incidence, risk factors, and the applicability of current screening criteria. Br J Ophthalmol 2008; 92 (2) 167-169
• 8 Larsson E, Holmström G. Screening for retinopathy of prematurity: evaluation and modification of guidelines. Br J Ophthalmol 2002; 86 (12) 1399-1402
• 9 Larsson E, Carle-Petrelius B, Cernerud G, Ots L, Wallin A, Holmström G. Incidence of ROP in two consecutive Swedish population based studies. Br J Ophthalmol 2002; 86 (10) 1122-1126
• 10 Kuo HK, Chen CC, Chen YH , et al. Incidence and result of treatment-demanding retinopathy of prematurity using revised U.S. screening guidelines. Am J Perinatol 2012; 29 (10) 827-831
• 11 Löfqvist C, Hansen-Pupp I, Andersson E , et al. Validation of a new retinopathy of prematurity screening method monitoring longitudinal postnatal weight and insulinlike growth factor I. Arch Ophthalmol 2009; 127 (5) 622-627
• 12 Wu C, Vanderveen DK, Hellström A, Löfqvist C, Smith LE. Longitudinal postnatal weight measurements for the prediction of retinopathy of prematurity. Arch Ophthalmol 2010; 128 (4) 443-447
• 13 Hård AL, Löfqvist C, Fortes Filho JB, Procianoy RS, Smith L, Hellström A. Predicting proliferative retinopathy in a Brazilian population of preterm infants with the screening algorithm WINROP. Arch Ophthalmol 2010; 128 (11) 1432-1436
• 14 Flückiger S, Bucher HU, Hellström A, Lövqist C, Sturm V, Arri SJ. [The early postnatal weight gain as a predictor of retinopathy of prematurity]. Klin Monatsbl Augenheilkd 2011; 228 (4) 306-310
• 15 Wu C, Löfqvist C, Smith LE, VanderVeen DK, Hellström A ; WINROP Consortium. Importance of early postnatal weight gain for normal retinal angiogenesis in very preterm infants: a multicenter study analyzing weight velocity deviations for the prediction of retinopathy of prematurity. Arch Ophthalmol 2012; 130 (8) 992-999
• 16 Lundgren P, Stoltz Sjöström E, Domellöf M , et al. WINROP identifies severe retinopathy of prematurity at an early stage in a nation-based cohort of extremely preterm infants. PLoS ONE 2013; 8 (9) e73256
• 17 Sun H, Kang W, Cheng X , et al. The use of the WINROP screening algorithm for the prediction of retinopathy of prematurity in a Chinese population. Neonatology 2013; 104 (2) 127-132
• 18 Choi JH, Löfqvist C, Hellström A, Heo H. Efficacy of the screening algorithm WINROP in a Korean population of preterm infants. JAMA Ophthalmol 2013; 131 (1) 62-66
• 19 Zepeda-Romero LC, Hård AL, Gomez-Ruiz LM , et al. Prediction of retinopathy of prematurity using the screening algorithm WINROP in a Mexican population of preterm infants. Arch Ophthalmol 2012; 130 (6) 720-723
• 20 Slidsborg C, Olesen HB, Jensen PK , et al. Treatment for retinopathy of prematurity in Denmark in a ten-year period (1996 2005): is the incidence increasing? . Pediatrics 2008; 121 (1) 97-105
• 21 Schiariti V, Matsuba C, Houbé JS, Synnes AR. Severe retinopathy of prematurity and visual outcomes in British Columbia: a 10-year analysis. J Perinatol 2008; 28 (8) 566-572
• 22 Laws DE, Morton C, Weindling M, Clark D. Systemic effects of screening for retinopathy of prematurity. Br J Ophthalmol 1996; 80 (5) 425-428
• 23 Palmer EA, Hardy RJ, Dobson V , et al; Cryotherapy for Retinopathy of Prematurity Cooperative Group. 15-year outcomes following threshold retinopathy of prematurity: final results from the multicenter trial of cryotherapy for retinopathy of prematurity. Arch Ophthalmol 2005; 123 (3) 311-318
• 24 Good WV, Hardy RJ, Dobson V , et al; Early Treatment for Retinopathy of Prematurity Cooperative Group. Final visual acuity results in the early treatment for retinopathy of prematurity study. Arch Ophthalmol 2010; 128 (6) 663-671
• 25 Piyasena C, Dhaliwal C, Russell H , et al. Prediction of severe retinopathy of prematurity using the WINROP algorithm in a birth cohort in South East Scotland. Arch Dis Child Fetal Neonatal Ed 2013;
• 26 Pelken L, Maier RF. [Risk factors and prevention of retinopathy of prematurity]. Ophthalmologe 2008; 105 (12) 1108-1113
• 27 Gilbert C. Retinopathy of prematurity: a global perspective of the epidemics, population of babies at risk and implications for control. Early Hum Dev 2008; 84 (2) 77-82
• 28 Fang PC, Kuo HK, Ko TY, Chen CC, Hwang KP, Chung MY. Retinopathy of prematurity in larger preterm infants. Am J Perinatol 2006; 23 (5) 273-277