Refining evidence-based retinopathy of prematurity screening guidelines: The SCREENROP study
Authors: Sabri Kourosh , Shivananda Sandesh , Farrokhyar Forough , Selvitella Alessandro , Easterbrook B Kin Bethany , Seidlitz Wendy , Lee Shoo K ,   Canadian Neonatal Network and the Canadian Association of Pediatric Ophthalmology and Strabismus, Whelan Kaitlyn , Shah Prakesh S , Gardiner Jane , Ye Xiang Y , Budning Andrew , Clark Ian , Erraguntla Vasudha , Fournier Anick , Hamel Patrick , Heon Elise , Isaza-Zapata Gloria , Lyons Christopher , MacDonald Ian , Makar Inas , Kertes Peter , Greve Mark , Tennant Matthew , Mireskandari Kamiar , Nazemi Fariba , O’Connor Michael , Ospina Luis , Pegado Victor , Robitaille Johane , Sharan Sapna , Sigesmund Dayle , Solarte Carlos , Strube Yi Ning , Superstein Rosanne , Tehrani Nasrin , Mulholland Conor , Nabi Naeem , Synnes Anne , Ting Joseph , Rouvinez-Bouali Nicole , Piedboeuf Bruno , Drolet Christine , Bertelle Valerie , Masse Edith , Makary Hala , Yee Wendy , Harrison Adele , Seshia Molly , Barrington Keith , Afifi Jehier , Deshpandey Akhil , Pelausa Ermelinda , Dow Kimberly , Riley Patricia , Claveau Martine , Aziz Khalid , Cieslak Zenon , Kalapesi Zarin , Sankaran Koravangattu , Faucher Daniel , Alvaro Ruben , Canning Roderick , da Silva Orlando , Ojah Cecil , Monterrosa Luis , Dunn Michael , Sorokan Todd , Kajetanowicz Andrzej , Nwaesei Chuks , Fajardo Carlos , Husain Sahira , Xia Sunny , Viscardi Virginia , Yeh Sonny , Schneider Laura , Whelan Kaitlyn , Shah Prakesh S , Gardiner Jane , Ye Xiang Y , Budning Andrew , Clark Ian , Erraguntla Vasudha , Fournier Anick , Hamel Patrick , Heon Elise , Isaza-Zapata Gloria , Lyons Christopher , MacDonald Ian , Makar Inas , Kertes Peter , Greve Mark , Tennant Matthew , Mireskandari Kamiar , Nazemi Fariba , O’Connor Michael , Ospina Luis , Pegado Victor , Robitaille Johane , Sharan Sapna , Sigesmund Dayle , Solarte Carlos , Strube Yi Ning , Superstein Rosanne , Tehrani Nasrin , Mulholland Conor , Nabi Naeem , Synnes Anne , Ting Joseph , Rouvinez-Bouali Nicole , Piedboeuf Bruno , Drolet Christine , Bertelle Valerie , Masse Edith , Makary Hala , Yee Wendy , Harrison Adele , Seshia Molly , Barrington Keith , Afifi Jehier , Deshpandey Akhil , Pelausa Ermelinda , Dow Kimberly , Riley Patricia , Claveau Martine , Aziz Khalid , Cieslak Zenon , Kalapesi Zarin , Sankaran Koravangattu , Faucher Daniel , Alvaro Ruben , Canning Roderick , da Silva Orlando , Ojah Cecil , Monterrosa Luis , Dunn Michael , Sorokan Todd , Kajetanowicz Andrzej , Nwaesei Chuks , Fajardo Carlos , Husain Sahira , Xia Sunny , Viscardi Virginia , Yeh Sonny , Schneider Laura 
Published: August 2019

Purpose

Retinopathy of prematurity (ROP) is a potentially blinding condition affecting premature infants for which less than 10% of babies undergoing screening require treatment. This study assessed and validated predictors of developing clinically significant ROP (type 2 or worse) and ROP requiring treatment.

Design

Nationwide retrospective cohort study.

Methods

This study included infants born between January 2014 and June 2016, admitted to level 3 neonatal intensive care units across Canada who underwent ROP screening. Data were derived from the Canadian Neonatal Network database. Predefined ≥ 1% risk for clinically significant retinopathy or prematurity and ROP requiring treatment was set as threshold for screening. Thirty-two potential predictors were analyzed, to identify and validate the most important ones for predicting clinically significant ROP. The predictors were determined on a derivation cohort and tested on a validation cohort. Multivariable logistic regression modeling was used for analysis.

Results

Using a sample of 4,888 babies and analyzing 32 potential predictors, capturing babies with ≥1% risk of developing clinically significant ROP equated to screening babies with birth weight (BW) &lt;1,300 g or gestational age (GA) &lt;30 weeks while capturing babies with ≥1% risk of requiring ROP treatment equated to screening babies with BW &lt;1,200 g or GA &lt;29 weeks.

Conclusions

The Canadian ROP screening criteria can be modified to screen babies with BW &lt;1,200 g or GA &lt;30 weeks. Using these criteria, babies requiring treatment would be identified while reducing the number of babies screened unnecessarily.