Abstract：
To determine the applicability of current international and national retinopathy of prematurity (ROP) screening guidelines and to identify a suitable community-based screening criterion.
A retrospective study on premature neonates (≤37 weeks gestation) referred to a tertiary eye hospital ROP clinic in the north of Iran was conducted over a 10-year period. Neonates were classified as no ROP, with ROP and type 1 ROP. Data consisting of birth weight (BW), gestational age (GA) and chief risk factors were evaluated. Various screening criteria and currently established screening guidelines were applied and compared for applicability using a receiver operating characteristic curve.
A total of 716 neonates with a mean GA of 31.4 ± 2.8 weeks and BW of 1629 ± 502 grams were screened. The incidence of ROP was 22.9% and type 1 ROP requiring treatment was 0.28%. When applying the national Ministry of Health Guidelines, all neonates with type 1 ROP requiring treatment were identified; These criteria had a specificity of 7% for the diagnosis of type 1 ROP, and a large number of neonates (n=645) who are not at risk for type 1 ROP will be redundantly screened. Guidelines of the American Academy of Pediatrics and the UK would miss 4.5% of patients requiring ROP treatment. According to our data a threshold of GA≤32 weeks and/or BW ≤1600 grams demonstrated a sensitivity of 95.7% and specificity of 33.6% for the diagnosis of any ROP and a sensitivity of 100% and specificity of 26.8% for type 1 ROP requiring treatment.
The ideal ROP screening guideline is one that is very sensitive and identifies patients requiring treatment without delay. To minimize redundant screening while maintaining optimum ROP requiring treatment diagnosis, we proposed a new local evidence-based screening guideline.
A retrospective study on premature neonates (≤37 weeks gestation) referred to a tertiary eye hospital ROP clinic in the north of Iran was conducted over a 10-year period. Neonates were classified as no ROP, with ROP and type 1 ROP. Data consisting of birth weight (BW), gestational age (GA) and chief risk factors were evaluated. Various screening criteria and currently established screening guidelines were applied and compared for applicability using a receiver operating characteristic curve.
A total of 716 neonates with a mean GA of 31.4 ± 2.8 weeks and BW of 1629 ± 502 grams were screened. The incidence of ROP was 22.9% and type 1 ROP requiring treatment was 0.28%. When applying the national Ministry of Health Guidelines, all neonates with type 1 ROP requiring treatment were identified; These criteria had a specificity of 7% for the diagnosis of type 1 ROP, and a large number of neonates (n=645) who are not at risk for type 1 ROP will be redundantly screened. Guidelines of the American Academy of Pediatrics and the UK would miss 4.5% of patients requiring ROP treatment. According to our data a threshold of GA≤32 weeks and/or BW ≤1600 grams demonstrated a sensitivity of 95.7% and specificity of 33.6% for the diagnosis of any ROP and a sensitivity of 100% and specificity of 26.8% for type 1 ROP requiring treatment.
The ideal ROP screening guideline is one that is very sensitive and identifies patients requiring treatment without delay. To minimize redundant screening while maintaining optimum ROP requiring treatment diagnosis, we proposed a new local evidence-based screening guideline.
摘要：
确定当前国际和国家早产儿视网膜病变（ROP）筛查指南的适用性，并确定合适的基于社区的筛查标准。
对伊朗北部一家三级眼科医院ROP诊所的早产儿（≤妊娠37周）进行了为期10年的回顾性研究。新生儿被归类为无ROP,ROP和1型ROP。由出生体重(BW)组成的数据，评估孕龄(GA)和主要危险因素.应用了各种筛选标准和当前建立的筛选指南，并使用受试者工作特征曲线比较了适用性。
总共筛选了716名新生儿，平均GA为31.4±2.8周，BW为1629±502克。ROP发生率为22.9%，需要治疗的1型ROP发生率为0.28%。在应用国家卫生部指南时，确定了所有需要治疗的1型ROP新生儿；这些标准对1型ROP的诊断具有7％的特异性，大量没有1型ROP风险的新生儿(n=645)将被冗余筛查。美国儿科学会和英国的指南将错过4.5％需要ROP治疗的患者。根据我们的数据，GA≤32周和/或BW≤1600克的阈值对诊断任何ROP的敏感性为95.7％，特异性为33.6％，对需要治疗的1型ROP的敏感性为100％，特异性为26.8％。
理想的ROP筛查指南是非常敏感的指南，可以识别需要治疗的患者。为了最大限度地减少冗余筛查，同时保持需要治疗诊断的最佳ROP，我们提出了一项新的地方循证筛查指南.
对伊朗北部一家三级眼科医院ROP诊所的早产儿（≤妊娠37周）进行了为期10年的回顾性研究。新生儿被归类为无ROP,ROP和1型ROP。由出生体重(BW)组成的数据，评估孕龄(GA)和主要危险因素.应用了各种筛选标准和当前建立的筛选指南，并使用受试者工作特征曲线比较了适用性。
总共筛选了716名新生儿，平均GA为31.4±2.8周，BW为1629±502克。ROP发生率为22.9%，需要治疗的1型ROP发生率为0.28%。在应用国家卫生部指南时，确定了所有需要治疗的1型ROP新生儿；这些标准对1型ROP的诊断具有7％的特异性，大量没有1型ROP风险的新生儿(n=645)将被冗余筛查。美国儿科学会和英国的指南将错过4.5％需要ROP治疗的患者。根据我们的数据，GA≤32周和/或BW≤1600克的阈值对诊断任何ROP的敏感性为95.7％，特异性为33.6％，对需要治疗的1型ROP的敏感性为100％，特异性为26.8％。
理想的ROP筛查指南是非常敏感的指南，可以识别需要治疗的患者。为了最大限度地减少冗余筛查，同时保持需要治疗诊断的最佳ROP，我们提出了一项新的地方循证筛查指南.
