Bai Yi-Chen, Wu Rong, Chen Si-Zhe, Wei Shi-Yu, Chen Hui-Jie, Chen Yan-Chen, Feng Song-Fu, Lu Xiao-He
Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China.
Department of Ophthalmology, Liuzhou People's Hospital, Liuzhou 545006, Guangxi Zhuang Autonomous Region, China.
Int J Ophthalmol. 2021 Jan 18;14(1):127-132. doi: 10.18240/ijo.2021.01.18. eCollection 2021.
To evaluate the predicting efficacy of severe retinopathy of prematurity (ROP) by the WINROP algorithm (http://winrop.com) in Southern China.
All preterm infants with the gestational age (GA) less than 32wk were included. Their ROP screening results and serial postnatal body weight were analysed retrospectively. Weekly body weight was entered into and measured by the WINROP system. The outcomes were analysed, and the sensitivity, specificity, positive predictive value and negative predictive value (NPV) were calculated.
Totally 432 infants with a median GA of 30.0 (24.0-31.9)wk, and a median birth weight (BW) of 1360 (540-2700) g were included. Among these 432 infants, 50 were diagnosed as type 1 ROP but only 28 were identified by the WINROP algorithm. The sensitivity was 56% (28/50) and the NPV was 92% (252/274). However, for infants with BW <1000 g or GA <28wk, the sensitivity was 93.8% (15/16) and 93.3% (14/15), respectively. Meanwhile, with several postnatal complications added as additional risk factors, the sensitivity was increased to 96% (48/50).
The sensitivity of the WINROP algorithm from the Southern Chinese cohort is not as high as that reported in developed countries. This algorithm is effective for detecting severe ROP from extremely small or preterm infants. Modification of the algorithm with additional risk factors could improve the predictive value for infants with a GA>28wk in China.
评估WINROP算法(http://winrop.com)对中国南方地区早产儿严重视网膜病变(ROP)的预测效能。
纳入所有孕周(GA)小于32周的早产儿。回顾性分析其ROP筛查结果及出生后系列体重。每周体重录入WINROP系统并由该系统测量。分析结果,计算敏感度、特异度、阳性预测值和阴性预测值(NPV)。
共纳入432例婴儿,中位GA为30.0(24.0 - 31.9)周,中位出生体重(BW)为1360(540 - 2700)g。在这432例婴儿中,50例被诊断为1型ROP,但WINROP算法仅识别出28例。敏感度为56%(28/50),NPV为92%(252/274)。然而,对于BW<1000 g或GA<28周的婴儿,敏感度分别为93.8%(15/16)和93.3%(14/15)。同时,增加几种产后并发症作为额外危险因素后,敏感度提高到96%(48/50)。
中国南方队列中WINROP算法的敏感度不如发达国家报道的高。该算法对检测极小或早产儿的严重ROP有效。增加额外危险因素对算法进行修正可提高其对中国GA>28周婴儿的预测价值。