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Clinical Sciences
Aug 2012

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

Author Affiliations

Author Affiliations: Department of Ophthalmology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts (Drs Wu, Smith, and VanderVeen); and Department of Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Drs Löfqvist and Hellström).

Arch Ophthalmol. 2012;130(8):992-999. doi:10.1001/archophthalmol.2012.243

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 care units. 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 1 ROP) and alarm (at risk for developing type 1 ROP). 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.