Validation of the “TWO-ROP” Algorithm at a Multi-Neonatal Intensive Care Unit Tertiary Referral Center

IF 4.4 Q1 OPHTHALMOLOGY

Ophthalmology. Retina Pub Date : 2025-01-01 DOI:10.1016/j.oret.2024.07.010

Nimesh A. Patel MD , Francisco Altamirano MD , Sandra Hoyek MD , Hanna De Bruyn BS , Anne Fulton MD , Ryan Gise MD , Iason S. Mantagos MD, PhD , Carolyn Wu MD , Efren Gonzalez MD , Deborah K. VanderVeen MD

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Abstract

Purpose

We aim to validate the previously published TWO-ROP algorithm on an external data set.

Design

Retrospective consecutive study.

Subjects

Infants screened for retinopathy of prematurity (ROP) between January 2013 and August 2023 at a tertiary referral multi-site.

Methods

Infants with higher birth weight (BW) and greater gestational age (GA) were included and stratified into 3 groups as follows: group 1 (BW <1500 g, GA ≥30 weeks), group 2 (BW ≥1500 g, GA <30 weeks), and group 3 (BW ≥1500 g, GA ≥30 weeks).

Main Outcome Measures

The rate of ROP, treatment-warranted ROP (TW-ROP), and number of inpatient examinations were evaluated in the 3 groups.

Results

In total, 1095 (33.8%) patients met the inclusion criteria. The number of patients in groups 1, 2, and 3 was 837 (76.4%), 72 (6.6%), and 186 (17.0%), respectively. Retinopathy of prematurity was detected in 120 (11.0%) patients; the rate was 9.8% in group 1, 20.8% in group 2, and 12.4% in group 3 (P = 0.013). The overall mean number of inpatient examinations for patients undergoing traditional, TWO-ROP 36-week, and TWO-ROP 40-week screening systems was 1.95, 1.43, and 0.99, respectively (P < 0.001). Stage 3 was found in 9 eyes of 5 patients (0.5%, all zone II). Three eyes of 2 patients (0.2%) had plus disease. Two patients had bilateral laser treatment at 44 and 39.4 weeks postconceptional age (PCA); 3 out of 4 of these eyes met type 1 treatment criteria. Overall, the ROP screening burden saved was 9.0% and 16.7% for the TWO-ROP 36-week and 40-week systems, respectively. The sensitivity for TW-ROP was 100% for TWO-ROP 36-week system and 99.4% for TWO-ROP 40-week system.

Conclusion

The TWO-ROP algorithm can reduce the number of inpatient examinations while maintaining safety. To ensure timely management, we recommend that the single first ROP examination occur at 38 to 39 weeks PCA.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

查看原文本刊更多论文

在一个多新生儿重症监护室三级转诊中心验证 "TWO-ROP "算法。

目的：我们的目的是在外部数据集上验证之前发布的 TWO-ROP 算法：设计：回顾性连续研究：2013年1月至2023年8月期间在一家三级转诊多站点接受早产儿视网膜病变（ROP）筛查的婴儿：方法：纳入出生体重（BW）较高、胎龄（GA）较长的婴儿，并将其分为以下三组：第一组（BW主要结局指标：主要结果指标：对三组婴儿的视网膜病变率、治疗需要的视网膜病变率（TW-ROP）和住院检查次数进行评估：1,095（33.8%）名患者符合纳入标准。第一、二、三组患者人数分别为 837 人（76.4%）、72 人（6.6%）和 186 人（17.0%）。有 120 名（11.0%）患者被检测出患有 ROP；第一组的比率为 9.8%，第二组为 20.8%，第三组为 12.4%（P=0.013）。接受传统筛查系统、TWO-ROP 36 周筛查系统和 TWO-ROP 40 周筛查系统的患者的住院检查总平均次数分别为 1.95 次、1.43 次和 0.99 次（p 结论：TWO-ROP 算法是一种新的筛查系统，它能有效提高筛查效率：TWO-ROP 算法可以减少住院检查次数，同时保证安全性。为确保及时处理，我们建议在受孕后 38-39 周进行首次 ROP 单次检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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