Fadakar Kaveh, Abbas Haider, Soltani Shahgoli Sahel, Tuli Sonal, Farahani Afsar, Imani Fooladi Marjan, Taslimi Taleghani Naeeme, Esfandiarifard Shaghayegh, Roohipourmoallai Ramak, Davoudi Samaneh, Chen Jinghua, Khoshnood Shariati Maryam, Karkhaneh Reza, Ebrahimiadib Nazanin
Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, University of Florida College of Medicine, Gainesville, FL, USA.
Med Hypothesis Discov Innov Ophthalmol. 2022 Sep 23;11(2):77-84. eCollection 2022 Summer.
Retinopathy of prematurity (ROP) is a leading cause of irreversible blindness in infants. The Postnatal Growth and ROP (G-ROP) study proposed new screening criteria for ROP. This study aimed to validate the G-ROP screening criteria in a group of Iranian premature infants who were treated in the neonatal intensive care unit (NICU) for at least 40 days.
In this retrospective study, we extracted the data pertaining to infants admitted to the NICU from January 2020 to December 2021. We screened all the included infants for ROP based on the Iranian national screening criteria. We applied the G-ROP criteria to our study population, and if no criterion was met, the infant was exempted from ROP screening. We determined the sensitivity and specificity of the G-ROP guidelines for ROP detection, along with its capacity for predicting the requirement for ROP treatment. Moreover, we compared the G-ROP guidelines with the Iranian and North American guidelines for ROP screening.
A total of 166 premature infants with complete datasets were included: 130 had ROP, of whom 61 were treated. There were 109 female infants (65.7%). The mean (standard deviation [SD]) birth weight and gestational age were 1080 (256) g and 28.28 (1.97) weeks, respectively. Applying the G-ROP criteria, 127 of 130 infants with ROP were identified (sensitivity, 97.69%; 95% confidence interval [CI], 95.11% - 100%), and of 36 infants without ROP, three were correctly excluded (specificity, 8.33%; 95% CI, 0% - 17.36%). The G-ROP criteria did not fail to identify infants who required treatment for ROP (sensitivity, 100%; 95% CI, 98.29 - 100) and had a specificity of 8.69% (95% CI, 2.04% - 15.34%). Although the Iranian and North American criteria had 100% sensitivity for infants with any stage of ROP, they could not detect infants without ROP (0% specificity).
The G-ROP screening criteria had a sensitivity of 100% in identifying infants requiring treatment for ROP in our high-risk group; however, specificity was not sufficiently high. Further studies with larger numbers of referred infants could confirm a decrease in the burden of retinal examinations using these criteria.
早产儿视网膜病变（ROP）是婴儿不可逆失明的主要原因。产后生长与ROP（G-ROP）研究提出了新的ROP筛查标准。本研究旨在验证一组在新生儿重症监护病房（NICU）接受至少40天治疗的伊朗早产儿的G-ROP筛查标准。
在这项回顾性研究中，我们提取了2020年1月至2021年12月入住NICU的婴儿的数据。我们根据伊朗国家筛查标准对所有纳入的婴儿进行ROP筛查。我们将G-ROP标准应用于我们的研究人群，如果没有符合任何标准，则该婴儿可免于ROP筛查。我们确定了G-ROP指南对ROP检测的敏感性和特异性，以及其预测ROP治疗需求的能力。此外，我们将G-ROP指南与伊朗和北美的ROP筛查指南进行了比较。
共纳入166例具有完整数据集的早产儿：130例患有ROP，其中61例接受了治疗。有109例女婴（65.7%）。平均（标准差[SD]）出生体重和胎龄分别为1080（256）g和28.28（1.97）周。应用G-ROP标准，130例ROP婴儿中有127例被识别（敏感性，97.69%；95%置信区间[CI]，95.11% - 100%），36例无ROP的婴儿中有3例被正确排除（特异性，8.33%；95%CI，0% - 17.36%）。G-ROP标准没有未能识别出需要进行ROP治疗的婴儿（敏感性，100%；95%CI，98.29 - 100），特异性为8.69%（95%CI，2.04% - 15.34%）。尽管伊朗和北美的标准对任何阶段ROP的婴儿敏感性均为100%，但它们无法检测出无ROP的婴儿（特异性为0%）。
G-ROP筛查标准在识别我们高危组中需要进行ROP治疗的婴儿时敏感性为100%；然而，特异性不够高。对更多转诊婴儿进行的进一步研究可以证实使用这些标准可减轻视网膜检查的负担。
