Evaluation of a Risk Screening Tool for Retinopathy of Prematurity (ROP) in a German Cohort.

PURPOSE

To assess the efficacy of the DIGIROP-Birth algorithm in identifying infants at risk for developing retinopathy of prematurity (ROP).

METHODS

In a retrospective study, we included preterm infants over 11 years, 2010-2020, meeting the inclusion criteria for the DIGIROP-Birth calculator (24 + 0/7 to 30 + 6/7 weeks of gestational age). We assessed the validity of DIGIROP-Birth using receiver-operating characteristic (ROC) curves and calculated area-under-curve (AUC), sensitivity, specificity, and positive and negative predictive values.

RESULTS

897 infants were included in the analysis. The median age of the first ophthalmological examination was 40 days (IQR 32-50), the median gestational age was 198 days (IQR 185-209; corresponding to 28 + 2/7 gestational weeks), median birth weight was 1000 g (IQR 790-1300). Of 897 screened children, 458 (51.1%) were diagnosed with ROP, and 34 of 897 (3.8%) required treatment.Analysis of ROP requiring treatment predicted by DIGIROP showed an AUC of 0.860 [95%-CI 0.795-0.925]. An equilibrium of sensitivity and specificity existed at a probability of 4.12%. The positive predictive value was 10.95%, and the negative predictive value was 99.36%. Independent significant peri- and postnatal risk factors were emergency cesarean section and mass blood transfusions.

CONCLUSIONS

The DIGIROP-Birth calculator showed good predictive power in our studied population, with an incidence of 3.79% for therapy-requiring ROP. Peri- and postnatal risk factors should be included in ROP screening.