Validation of the postnatal growth and retinopathy of prematurity (G-ROP) screening criteria in a Thai cohort

Abstract

Purpose: To validate Postnatal Growth and Retinopathy of Prematurity (G-ROP) criteria for Thai infants. Study design: A retrospective review of infants receiving ROP screening during 2009–2020. Methods: Baseline characteristics, clinical progression and final ROP outcomes were collected. G-ROP was applied to infants who met at least one of the following 6 criteria: birth weight (BW) below 1051 g, gestational age (GA) under 28 weeks, weight gain (WG) less than 120 g during postnatal day 10–19, WG less than 180 g during day 20–29, WG less than 170 g during day 30–39 and hydrocephalus. Results: A total of 684 infants (boys, 53.4%) were included. Median (IQR) BW was 1200 (960–1470) grams and median GA was 30 (28–32) weeks. Prevalence of ROP was 26.6%, with 28 (4.1%) having type 1, 19 (2.8%) type 2 and, 135 (19.7%) having other ROP. Treatment was performed in 26 infants (3.8%). Sensitivity of G-ROP to include type 1, 2 or treatment-requiring ROP cases was 100% with 36.9% specificity, excluding 235 (34.4%) cases of unnecessary screening. To adjust for our setting of initial eye examination at 4 weeks’ postnatal date, the last 2 criteria of G-ROP were replaced by the occurrence of grade 3 or 4 intraventricular hemorrhage (IVH). This modified G-ROP criteria yielded 100% sensitivity, 42.5% specificity and excluded 271 (39.6%) cases of unnecessary screening. Conclusion: G-ROP criteria can be applied to our hospital setting. Occurrence of IVH grade 3 or 4 was proposed as an alternative in modified G-ROP criteria.