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Multicenter Study
. 2012 Aug;130(8):992-9.
doi: 10.1001/archophthalmol.2012.243.

Importance of early postnatal weight gain for normal retinal angiogenesis in very preterm infants: a multicenter study analyzing weight velocity deviations for the prediction of retinopathy of prematurity

Carolyn Wu  1 , Chatarina Löfqvist, Lois E H Smith, Deborah K VanderVeen, Ann Hellström; WINROP Consortium
Collaborators, Affiliations
Multicenter Study

Importance of early postnatal weight gain for normal retinal angiogenesis in very preterm infants: a multicenter study analyzing weight velocity deviations for the prediction of retinopathy of prematurity

Carolyn Wu et al. Arch Ophthalmol. 2012 Aug.

Abstract

Objective: To assess WINROP (https://winrop.com), an algorithm using postnatal weight measurements, as a tool for the prediction of retinopathy of prematurity (ROP) in a large geographically and racially diverse study population.

Methods: WINROP analysis was performed retrospectively on conventionally at-risk infants from 10 neonatal intensive careunits.Weight measurements were entered into WINROP, which signals an alarm for an abnormal weight gain rate. Infants were classified into categories of no alarm (unlikely to develop type 1ROP)and alarm (at risk for developing type 1ROP).Use of WINROP requires that an infant has (1) gestational age less than 32 weeks at birth, (2) weekly weight measurements,(3) physiologic weight gain,and(4)absence of other pathologic retinal vascular disease.

Results: A total of 1706 infants with a median gestational age of 28 weeks (range, 22-31 weeks) and median birth weight of 1016 g (range, 378-2240 g) were included in the study analysis. An alarm occurred in 1101 infants (64.5%), with a median time from birth to alarm of 3 weeks (range, 0-12 weeks) and from alarm to treatment of 8 weeks (range, 1 day to 22 weeks). The sensitivity of WINROP was 98.6% and the negative predictive value was 99.7%. Two infants with type 1 ROP requiring treatment after 40 weeks' postmenstrual age did not receive an alarm.

Conclusion: The WINROP system is a useful adjunct for ROP screening that identifies high-risk infants early to optimize care and potentially reduce the overall number of diagnostic ROP examinations.

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Figures

Figure 1
Figure 1
Flowchart of the study population. FEVR indicates familial exudative vitreoretinopathy; GA, gestational age; WINROP, weight, insulinlike growth factor, neonatal retinopathy of prematurity (ROP).
Figure 2
Figure 2
Time from birth to alarm (A), alarm to prethreshold (PT) retinopathy of prematurity (ROP) (B), and alarm to ROP treatment (C) in infants with type 1 ROP.
Figure 3
Figure 3
Risk of type 1 retinopathy of prematurity (ROP) after an alarm by gestational age.
See this image and copyright information in PMC

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