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Reduction in screening for retinopathy of prematurity through risk factor adjusted inclusion criteria
  1. A J van Sorge1,
  2. N E Schalij-Delfos1,
  3. F T Kerkhoff2,
  4. L J van Rijn3,
  5. J L A M van Hillegersberg4,
  6. I L A van Liempt5,
  7. P G M Peer6,
  8. H J Simonsz7,
  9. J U M Termote8
  1. 1Department of Ophthalmology, Leiden University Medical Centre, Leiden, The Netherlands
  2. 2Department of Ophthalmology, Maxima Medical Centre, Veldhoven, The Netherlands
  3. 3Department of Ophthalmology, VU Medical Centre, Amsterdam, The Netherlands
  4. 4Department of Neonatology, St Antonius, Nieuwegein, The Netherlands
  5. 5Department of Ophthalmology, Amphia Hospital, Breda, The Netherlands
  6. 6Department for Health Evidence, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  7. 7Department of Ophthalmology, Sophia Children's Hospital-Erasmus MC, Rotterdam, The Netherlands
  8. 8Department of Neonatology, Wilhelmina Children's Hospital-University Medical Centre, Utrecht, The Netherlands
  1. Correspondence to Dr A J van Sorge, Department of Ophthalmology, Leiden University Medical Centre, PO Box 9600, Leiden 2300 RC, The Netherlands; a.j.van_sorge{at}lumc.nl

Abstract

Aims To develop a new national screening guideline for retinopathy of prematurity (ROP).

Methods Included were infants of the 2009 prospective ROP inventory in The Netherlands with gestational age (GA) <32 weeks and/or birth weight (BW) <1500 g. Five models were studied, based on GA and BW in combination with no, one or a set of five risk factors for ROP. Risk factors were determined by logistic regression. In MEDLINE and EMBASE, additional risk factors were searched. A precondition was that no infants with severe ROP would be missed. Receiver operating characteristic curves or classical measures were used to determine diagnostic accuracy.

Results The model including all infants with severe ROP comprised screening of infants with GA <30 weeks and/or BW <1250 g and a selection of infants with GA 30–32 weeks and/or BW 1250–1500 g, with at least one of the following risk factors: artificial ventilation (AV), sepsis, necrotising enterocolitis (NEC), postnatal glucocorticoids or cardiotonica. This model would not detect 4.8% (95% CI 2.5% to 8.0%) of infants with mild ROP and would reduce infants eligible for screening by 29%.

Conclusions In The Netherlands, screening may be safely reduced using a new guideline based on GA, BW, AV, sepsis, NEC, postnatal glucocorticoids and cardiotonica.

  • Retina
  • Child health (paediatrics)

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