Elsevier

The Journal of Pediatrics

Volume 166, Issue 2, February 2015, Pages 257-261.e2
The Journal of Pediatrics

Original Article
Retinopathy of Prematurity Risk Prediction for Infants with Birth Weight Less than 1251 Grams

https://doi.org/10.1016/j.jpeds.2014.09.069Get rights and content

Objective

To predict retinopathy of prematurity (ROP) exam findings among infants with birth weight <1251 g from 32-40 weeks postmenstrual age (PMA).

Study design

Secondary analysis of 3714 eye exams from 1239 infants.

Results

The likelihood of developing type 1 ROP by 40 weeks PMA varied by gestational age (GA) (P < .001), from 33% for ≤25 weeks, 10% for 26 or 27 weeks, 4% for 28 or 29 weeks, and none for ≥30 weeks. By 40 weeks PMA, 51% with GA ≤27 weeks still needed subsequent exams. Previous exam findings, GA, and PMA were predictive of the development of type 1 ROP (area under the curve, 0.78) or mature retina (area under the curve, 0.85).

Conclusions

This analysis provides the opportunity for development of an ROP approach to estimate resource needs in the neonatal intensive care unit and to facilitate communication with families when planning discharge or transfer.

Section snippets

Methods

This is a secondary analysis of data from the e-ROP study. The e-ROP study was designed to enroll subjects with an increased likelihood of developing ROP. The study enrolled infants with BW <1251 g from 11 clinical centers in the US and 1 in Canada from 2011 through 2013. Subjects included those born within each center or transferred from other NICUs for clinical management (eg, chronic lung disease, necrotizing enterocolitis, posthemorrhagic hydrocephalus, progressive ROP). The exclusion

Results

There were 1257 infants enrolled in the e-ROP study with eye examination data. Among these, 13 subjects were excluded because all exams were conducted before 32 weeks PMA and 5 were excluded because all exams were conducted after 40 weeks PMA, leaving 1239 infants with a total of 3714 eye exams conducted from 32-40 weeks PMA for this analysis. Among the subjects included in this analysis, 7 died. Causes of death included infection, respiratory failure, necrotizing enterocolitis, and

Discussion

Without early detection and timely treatment of serious disease, ROP may lead to blindness. Although there are many clinical factors associated with the development of ROP, risk stratification has been challenging. Current guidelines recommend eye exam frequency primarily on BW, with the first exam driven by GA and PMA. We found that prediction of the findings of an eye exam based on GA, PMA, and previous exam findings was at least as good as comparative models that include a wide array of

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Cited by (9)

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Supported by the National Institutes of Health (U10EY017014). The authors declare no conflicts of interest.

Registered with ClinicalTrials.gov: NCT01264276.

∗

List of members of the e-ROP Study Cooperative Group is available at www.jpeds.com (Appendix)

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