Researchers develop easy-to-implement predictive screening tool for retinopathy

July 12, 2018, Children's Hospital of Philadelphia

A multi-hospital collaboration led by researchers at Children's Hospital of Philadelphia (CHOP) has found a simple method of determining which premature infants should be screened for retinopathy of prematurity (ROP). The recommendations have the potential to significantly reduce the number of eye examinations being done, easing the burden for babies, parents, nurses, and doctors who are already dealing with other issues associated with premature birth.

The findings were published in the journal JAMA Ophthalmology.

ROP is a potentially blinding eye disorder. In the United States, the disorder leads to blindness in between 400 and 600 each year, according to the National Eye Institute, and in some parts of the world ROP accounts for up to 60 percent of all childhood blindness. In order to reduce blindness from ROP, about 70,000 babies have repeated diagnostic in the United States each year, but only about 6% actually require laser surgery to try to prevent loss of vision. These babies are identified based upon birth weight and screening criteria. ROP and prematurity can also lead to eye problems later in life, such as severe near-sightedness, crossed eyes, and amblyopia ("lazy eye").

Scientific advances in the understanding of ROP have led to the development of predictive models for ROP for , with slow postnatal being an important new indicator for the disorder. While several hospitals, including CHOP, had tried to develop new models for screening for ROP, the models were based on relatively small numbers of patients and therefore did not consistently perform well enough to replace existing screening guidelines and reduce the number of examinations performed each year.

"We knew we had to use as large a cohort as possible so that we could develop a new model that is easy to use and more accurately identifies all premature infants who are at high-risk for developing severe ROP," said Gil Binenbaum, MD, MSCE, the Richard Shafritz Endowed Chair in Pediatric Ophthalmology Research, an attending surgeon in the Division of Ophthalmology at CHOP and senior author of the study.

The researchers analyzed 7,483 premature infants at risk for developing ROP across 29 hospitals in the United States and Canada between 2006 and 2012. They identified six key criteria that could be used to determine whether a child should receive examinations for ROP: birthweight below 1051 grams (about 2.3 pounds), gestational age younger than 28 weeks, and hydrocephalus, or slow weight gain during 3 time periods between ages 10 and 40 days (weight gain less than 120 grams during age 11 to 20 days, less than 180 grams during age 21 to 30 days, or less than 170 grams during age 31 to 40 days).

Using these six criteria, the researchers were able to correctly predict 100 percent of infants with "type 1 ROP," which requires treatment, while reducing the number of premature infants who would require examinations by 30.3 percent because they met none of the six criteria.

"The criteria we developed were highly sensitive; in fact, they were slightly more sensitive that the current screening guidelines, and yet they were much more accurate than the current guidelines," Dr. Binenbaum said. "Using these modified screening criteria could potentially reduce the number of babies who need to be examined by almost a third, which would be beneficial for those babies, and allow us to focus all our efforts on treating the who are at high risk for retinal detachment and blindness. The next step is to validate these encouraging results in a second large clinical study before actually using the new criteria in practice."

Explore further: Most premature infants receive early antibiotics

More information: Binenbaum et al, "Development of Modified Screening Criteria for Retinopathy of Prematurity," JAMA Ophthalmology, online July 12, 2018.

Related Stories

Most premature infants receive early antibiotics

May 30, 2018
(HealthDay)—Most premature infants receive empirical antibiotic therapy, according to a study published online May 25 in JAMA Network Open.

Telemedicine provides accurate diagnosis of rare cause of blindness in preemies

April 6, 2018
Accurately detecting a rare, but devastating cause of blindness in premature babies can be done as effectively with telemedicine as with traditional, in-person eye exams, a study published in JAMA Ophthalmology suggests. ...

AAP updates screening guide for retinopathy of prematurity

January 2, 2013
(HealthDay)—For the effective detection of retinopathy of prematurity (ROP), at-risk infants should receive carefully timed retinal examinations (based on their gestational age) by an ophthalmologist experienced in the ...

Breastfeeding may protect high-birthweight infants from childhood obesity

March 18, 2018
Breastfeeding may protect high-birthweight infants from having overweight or obesity as children, new research from South Korea suggests. The results will be presented in a poster on Sunday, March 18 at ENDO 2018, the 100th ...

Steroid treatment in very low birth weight infants may contribute to vision problems

August 16, 2016
Because of the beneficial effect of corticosteroids on lung function, especially in infants who are ventilator dependent, corticosteroids are, at times, administered to very low birth weight neonates to treat established ...

Remote photo screening effective in detecting eye damage in premature babies

July 10, 2014
(Medical Xpress)—Remote examination of eye scans can be nearly as effective as traditional eye exams in detecting premature newborns with a potentially blinding eye disorder, according to findings from a new federally funded ...

Recommended for you

Researchers are one step closer to developing eye drops to treat age-related macular degeneration

July 19, 2018
Scientists at the University of Birmingham are one step closer to developing an eye drop that could revolutionise treatment for age-related macular degeneration (AMD).

An orange a day keeps macular degeneration away: 15-year study

July 12, 2018
A new study has shown that people who regularly eat oranges are less likely to develop macular degeneration than people who do not eat oranges.

Injectable electronics offer powerful new tool in understanding how retinal cells work

June 28, 2018
Charles Lieber and his group are rewriting the rules of how scientists study retinal cells, and they're doing it with a single injection.

Why the eye could be the window to brain degeneration such as Alzheimer's disease

June 26, 2018
Researchers from Queen's University Belfast have shown for the first time that the eye could be a surrogate for brain degeneration like Alzheimer's disease (AD).

Microglia protect sensory cells needed for vision after retinal detachment

June 18, 2018
A research team at Massachusetts Eye and Ear has shown that microglia, the primary immune cells of the brain and retina, play a protective role in response to retinal detachment. Retinal detachment and subsequent degeneration ...

161 genetic factors for myopia identified

June 15, 2018
The international Consortium for Refractive Error and Myopia (CREAM) recently published the largest-ever genetic study of myopia in Nature Genetics. Researchers from the Gutenberg Health Study at the Medical Center of Johannes ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.