Biomedical papers, 2017 (vol. 161), issue 1

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017, 161(1):111-116 | 10.5507/bp.2016.061

Evaluation of the WinROP system for identifying retinopathy of prematurity in Czech preterm infants

Juraj Timkovica,b,c, Martina Pokryvkovad, Katerina Janurovae, Denisa Barinovad, Renata Polackovac,d, Petr Maseka,c
a Clinic of Ophthalmology, University Hospital Ostrava, Czech Republic
b Department of Pediatric Ophthalmology, Faculty of Medicine, Masaryk University, Brno and Faculty Hospital Brno, Czech Republic
c Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Czech Republic
d Department of Neonatology, University Hospital Ostrava, Czech Republic
e IT4Innovations National Supercomputing Center, VSB - Technical University of Ostrava, Czech Republic

Aims: Retinopathy of Prematurity (ROP) is a potentially serious condition that can afflict preterm infants. Timely and correct identification of individuals at risk of developing a serious form of ROP is therefore of paramount importance. WinROP is an online system for predicting ROP based on birth weight and weight increments. However, the results vary significantly for various populations. It has not been evaluated in the Czech population. This study evaluates the test characteristics (specificity, sensitivity, positive and negative predictive values) of the WinROP system in Czech preterm infants.

Methods: Data on 445 prematurely born infants included in the ROP screening program at the University Hospital Ostrava, Czech Republic, were retrospectively entered into the WinROP system and the outcomes of the WinROP and regular screening were compared.

Results: All 24 infants who developed high-risk (Type 1 or Type 2) ROP were correctly identified by the system. The sensitivity and negative predictive values for this group were 100%. However, the specificity and positive predictive values were substantially lower, resulting in a large number of false positives. Extending the analysis to low risk ROP, the system did not provide such reliable results.

Conclusions: The system is a valuable tool for identifying infants who are not likely to develop high-risk ROP and this could help to substantially reduce the number of preterm infants in need of regular ROP screening. It is not suitable for predicting the development of less serious forms of ROP which is however in accordance with the declared aims of the WinROP system.

Keywords: retinopathy of prematurity, WinROP system, early diagnosis of ROP, ROP prediction

Received: October 3, 2016; Accepted: November 29, 2016; Prepublished online: December 13, 2016; Published: March 27, 2017


References

  1. Hartnett ME, Lane RH. Effects of oxygen on the development and severity of retinopathy of prematurity. J Aapos 2013;17(3):229-34. Go to original source... Go to PubMed...
  2. Goncalves E, Nasser LS, Martelli DR, Alkmim IR, Mourao TV, Caldeira AP, Martelli H Jr. Incidence and risk factors for retinopathy of prematurity in a Brazilian reference service. Sao Paulo Med J 2014;132(2):85-91. Go to original source... Go to PubMed...
  3. Yau GSK, Lee JWY, Tam VTY, Yip S, Cheng E, Liu CC, Chu BC, Wong IY. Incidence and Risk Factors for Retinopathy of Prematurity in Multiple Gestations A Chinese Population Study. Medicine (Baltimore) 2015;94(18). Go to PubMed...
  4. Abrishami M, Maemori G-A, Boskabadi H, Yaeghobi Z, Mafi-Nejad S, Abrishami M. Incidence and Risk Factors of Retinopathy of Prematurity in Mashhad, Northeast Iran. Iran Red Crescent Med J 2013;15(3):229-33. Go to original source... Go to PubMed...
  5. Chen Y, Xun D, Wang YC, Wang B, Geng SH, Chen H, Li YT, Li XX. Incidence and Risk Factors of Retinopathy of Prematurity in Two Neonatal Intensive Care Units in North and South China. Chin Med J (Engl) 2015;128(7):914-18. Go to original source... Go to PubMed...
  6. Yanovitch TL, Siatkowski RM, McCaffree M, Corff KE. Retinopathy of prematurity in infants with birth weight >= 1250 grams - Incidence, severity, and screening guideline cost-analysis. J Aapos 2006;10(2):128-34. Go to original source... Go to PubMed...
  7. Port AD, Chan RVP, Ostmo S, Choi D, Chiang MF. Risk factors for retinopathy of prematurity: insights from outlier infants. Graefes Arch Clin Exp Ophthalmol 2014;252(10):1669-77. Go to original source... Go to PubMed...
  8. Li ML, Hsu SM, Chang YS, Shih MH, Lin YC, Lin CH, Tsai HJ, Tseng SH. Retinopathy of prematurity in southern Taiwan: A 10-year tertiary medical center study. J Formos Med Assoc 2013;112(8):445-53. Go to original source... Go to PubMed...
  9. Kumar P, Sankar MJ, Deorari A, Azad R, Chandra P, Agarwal R, Paul V. Risk Factors for Severe Retinopathy of Prematurity in Preterm Low Birth Weight Neonates. Indian J Pediatr 2011;78(7):812-16. Go to original source... Go to PubMed...
  10. Seiberth V, Linderkamp O. Risk factors in retinopathy of prematurity - A multivariate statistical analysis. Ophthalmologica 2000;214(2):131-35. Go to original source... Go to PubMed...
  11. Kavurt S, Ozcan B, Aydemir O, Bas AY, Demirel N. Risk of Retinopathy of Prematurity in Small for Gestational Age Premature Infants. Indian Pediatr 2014;51(10):804-06. Go to original source... Go to PubMed...
  12. Weintraub Z, Carmi N, Elouti H, Rumelt S. The association between stage 3 or higher retinopathy of prematurity and other disorders of prematurity. Can J Ophthalmol-J Can Ophtalmol 2011;46(5):419-24. Go to original source...
  13. Celebi ARC, Petricli IS, Hekimoglu E, Demirel N, Bas AY. The Incidence and Risk Factors of Severe Retinopathy of Prematurity in Extremely Low Birth Weight Infants in Turkey. Med Sci Monit 2014;20:1647-53. Go to original source... Go to PubMed...
  14. Fortes Filho JB, Eckert GU, Valiatti FB, Batista dos Santos PG, da Costa MC, Procianoy RS. The influence of gestational age on the dynamic behavior of other risk factors associated with retinopathy of prematurity (ROP). Graefes Arch Clin Exp Ophthalmol 2010;248(6):893-00. Go to original source... Go to PubMed...
  15. Hartnett ME. Pathophysiology and Mechanisms of Severe Retinopathy of Prematurity. Ophthalmology 2015;122(1):200-10. Go to original source... Go to PubMed...
  16. Hartnett ME. Studies on the pathogenesis of avascular retina and neovascularization into the vitreous in peripheral severe retinopathy of prematurity (an american ophthalmological society thesis). Trans Am Ophthalmol Soc 2010;108:96-119. Go to PubMed...
  17. Cavallaro G, Filippi L, Bagnoli P, La Marca G, Cristofori G, Raffaeli G, Padrini L, Araimo G, Fumagalli M, Groppo M, Dal Monte M, Osnaghi S, Fiorini P, Mosca F. The pathophysiology of retinopathy of prematurity: an update of previous and recent knowledge. Acta Ophthalmol (Copenh) 2014;92(1):2-20. Go to original source... Go to PubMed...
  18. Rivera JC, Sapieha P, Joyal JS, Duhamel F, Shao Z, Sitaras N, Picard E, Zhou E, Lachapelle P, Chemtob S. Understanding Retinopathy of Prematurity: Update on Pathogenesis. Neonatology 2011;100(4):343-53. Go to original source... Go to PubMed...
  19. Can E, Bulbul A, Uslu S, Bolat F, Comert S, Nuhoglu A. Early Aggressive Parenteral Nutrition Induced High Insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP3) Levels Can Prevent Risk of Retinopathy of Prematurity. Iran J Pediatr 2013;23(4):403-10. Go to PubMed...
  20. Smith LEH. IGF-1 and retinopathy of prematurity in the preterm infant. Biol Neonate 2005;88(3):237-44. Go to original source... Go to PubMed...
  21. Hard A-L, Smith LE, Hellstrom A. Nutrition, insulin-like growth factor-1 and retinopathy of prematurity. Semin Fetal Neonatal Med 2013;18(3):136-42. Go to original source...
  22. Hellström A, Smith LE, Dammann O. Retinopathy of prematurity. The Lancet 2013;382(9902):1445-57. Go to original source...
  23. Binenbaum G. Algorithms for the Prediction of Retinopathy of Prematurity Based on Postnatal Weight Gain. Clin Perinatol 2013;40(2):261-70. Go to original source... Go to PubMed...
  24. Wu C, Lofqvist C, Smith LEH, VanderVeen DK, Hellstrom A. 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):992-99. Go to original source... Go to PubMed...
  25. Lofqvist C, Andersson E, Sigurdsson J, Engstrom E, Hard AL, Niklasson A, Smith LEH, Hellstrom A. Longitudinal postnatal weight and insulin-like growth factor I measurements in the prediction of retinopathy of prematurity. Arch Ophthalmol 2006;124(12):1711-18. Go to original source... Go to PubMed...
  26. Wu C, VanderVeen DK, Hellstrom A, Lofqvist C, Smith LEH. Longitudinal Postnatal Weight Measurements for the Prediction of Retinopathy of Prematurity. Arch Ophthalmol 2010;128(4):443-47. Go to original source... Go to PubMed...
  27. Lundgren P, Kistner A, Andersson EM, Hansen PI, Holmstrom G, Ley D, Niklasson A, Smith LE, Wu C, Hellstrom A, Lofqvist C. Low Birth Weight Is a Risk Factor for Severe Retinopathy of Prematurity Depending on Gestational Age. Plos One 2014;9(10):e109460. Go to original source... Go to PubMed...
  28. Wikstrand MH, Hard A-L, Niklasson A, Smith L, Lofqvist C, Hellstrom A. Maternal and neonatal factors associated with poor early weight gain and later retinopathy of prematurity. Acta Paediatr 2011;100(12):1528-33. Go to original source... Go to PubMed...
  29. Husain SM, Sinha AK, Bunce C, Arora P, Lopez W, Mun KS, Reddy MA, Adams GG. Relationships between Maternal Ethnicity, Gestational Age, Birth Weight, Weight Gain, and Severe Retinopathy of Prematurity. J Pediatr 2013;163(1):67-72.
  30. Kemper AR, Wade KC, Hornik CP, Ying G, Baumritter A, Quinn GE. Retinopathy of Prematurity Risk Prediction for Infants with Birth Weight Less than 1251 Grams. J Pediatr 2015;166(2):257-61. Go to original source... Go to PubMed...
  31. Binenbaum G, Ying G, Quinn GE, Huang J, Dreiseitl S, Antigua J, Foroughi N, Abbasi S. The CHOP Postnatal Weight Gain, Birth Weight, and Gestational Age Retinopathy of Prematurity Risk Model. Arch Ophthalmol 2012;130(12):1560-65. Go to original source... Go to PubMed...
  32. Loqvist C, Hansen-Pupp I, Andersson E, Holm K, Smith LE, Ley D, Hellstrom A. Validation of a New Retinopathy of Prematurity Screening Method Monitoring Longitudinal Postnatal Weight and Insulinlike Growth Factor I. Arch Ophthalmol 2009;127(5):622-27. Go to original source... Go to PubMed...
  33. Lundgren P, Sjostrom ES, Domellof M, Smith L, Wu C, VanderVeen D, Hellstrom A, Lofqvist C. The Specificity of the WINROP Algorithm Can Be Significantly Increased by Reassessment of the WINROP Alarm. Neonatology 2015;108(2):152-56. Go to original source... Go to PubMed...
  34. Choi J-H, Lofqvist C, Hellstrom A, Heo H. Efficacy of the Screening Algorithm WINROP in a Korean Population of Preterm Infants. Jama Ophthalmol 2013;131(1):62-66. Go to original source... Go to PubMed...
  35. Hard A-L, Lofqvist C, Fortes Filho JB, Procianoy RS, Smith L, Hellstrom A. Predicting Proliferative Retinopathy in a Brazilian Population of Preterm Infants With the Screening Algorithm WINROP. Arch Ophthalmol 2010;128(11):1432-36. Go to original source... Go to PubMed...
  36. Zepeda-Romero LC, Hard AL, Gomez-Ruiz LM, Gutirrez-Padilla JA, Angulo-Castellanos E, Barrera-de-Leon JC, Ramirez-Valdivia JM, Gonzalez-Bernal C, Valtierra-Santiago CI, Garnica-Garcia E, Lofqvist C, Hellstrom A. Prediction of Retinopathy of Prematurity Using the Screening Algorithm WINROP in a Mexican Population of Preterm Infants. Arch Ophthalmol 2012;130(6):720-23. Go to original source... Go to PubMed...
  37. Sun H, Kang W, Cheng X, Chen C, Xiong H, Guo J, Zhou C, Zhang Y, Hellstrom A, Lofqvist C, Zhu C. The Use of the WINROP Screening Algorithm for the Prediction of Retinopathy of Prematurity in a Chinese Population. Neonatology 2013;104(2):127-32. Go to original source... Go to PubMed...
  38. Eriksson L, Liden U, Lofqvist C, Hellstrom A. WINROP can modify ROP screening praxis: a validation of WINROP in populations in Sormland and Vastmanland. Br J Ophthalmol 2014;98(7):964-66. Go to original source... Go to PubMed...
  39. Lundgren P, Sjostrom ES, Domellof M, Kallen K, Holmstrom G, Hard AL, Smith LE, Lofqvist C, Hellstrom A. 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. Go to original source... Go to PubMed...
  40. Good WV. Final results of the early treatment for retinopathy of prematurity (ETROP) randomized trial. Trans Am Ophthalmol Soc 2004;102:233-50. Go to PubMed...
  41. Good WV, Hardy RJ, Dobson V, Palmer EA, Phelps DL, Quintos M, Tung B, Early Treatment for Retinopathy of Prematuruty Cooperative Group. The incidence and course of retinopathy of prematurity: findings from the early treatment for retinopathy of prematurity study. Pediatrics 2005;116(1):15-23. Go to original source... Go to PubMed...
  42. Palmer EA, Flynn JT, Hardy RJ, Phelps DL, Phillips CL, Schaffer DB, Tung B. Incidence and Early Course of Retinopathy of Prematurity. Ophthalmology 1991;98(11):1628-40. Go to original source... Go to PubMed...
  43. Yang CY, Lien R, Yang PH, Chu SM, Hsu JF, Fu RH, Chiang MC. Analysis of incidence and risk factors of retinopathy of prematurity among very-low-birth-weight infants in North Taiwan. Pediatr Neonatol 2011;52(6):321-26. Go to original source... Go to PubMed...