Use of the WINROP Screening Algorithm for the Prediction of Retinopathy of Prematurity (ROP): A Hospital-Based Study

Abstract

Background: Retinopathy of prematurity (ROP) may be the blinding disease that affects the retina of neonates. WINROP utilizes the rate of postnatal weight increase as a replication of IGF-1 or uses weight increase and IGF-1 levels together as highly analytical markers for those infants at increased risk for the development of proliferative ROP. So this study was undertaken to find out the sensitivity and specificity of this algorithm concerning international screening guidelines to predict retinopathy of prematurity. Material & Methods: A prospective cross-sectional study was carried out in the Department of Neonatology, Bangladesh Shishu Hospital & Institute from January 2017 to December 2018. A total of 50 neonates (N=50) with proper documentation following the inclusion and exclusion criteria were confirmed as the study population. Informed written consent was obtained from all the parents or guardians after they were thoroughly briefed about the nature and purpose of the study. Data were processed and analyzed using statistical package for social sciences (SPSS-22 version) software (SPSS Inc., Chicago, IL, USA). The ethical review board of the Bangladesh Institute of Child Health approved the protocol of this study. Results: The mean gestational age was 29±1.17 weeks in ROP-positive cases and 31.79±0.51 weeks in ROP-negative cases. The mean weight was 1121.9±94.34 grams in ROP-positive cases and 1302.7±139.72 grams in ROP-negative cases. It was observed that the majority 92.3% of the ROP positive cases had weight gain ≤10gm/kg/day for 4 weeks but 87.5% of the ROP negative cases had weight gain >10gm/kg/day. The validity test of WINROP for the prediction of retinopathy has a sensitivity of 92.3%, specificity of 87.5%, and positive predictive value of 88.9% and negative predictive value of 91.3%. Low-grade ROP – In zone II or III and stage 1. High-grade ROP – In zone I and stage 2 or more and plus disease. Conclusion: Retinopathy of prematurity (ROP) is a severe eye infection that can affect premature neonates. In this study, WINROP predicted 92.3% sensitivity and 88.9% positive predictive value in comparison to the gold standard screening method for detecting ROP within 2 weeks of birth.