title: 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.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology, Children’s Hospital Boston, 300 Longwood Ave, Fegan 4, Boston, MA 02115, USA. carolyn.wu@childrens.harvard.edu
authors.forename: Carolyn
authors.initials: C
authors.lastname: Wu
authors.forename: Chatarina
authors.initials: C
authors.lastname: Löfqvist
authors.forename: Lois E H
authors.initials: LE
authors.lastname: Smith
authors.forename: Deborah K
authors.initials: DK
authors.lastname: VanderVeen
authors.forename: Ann
authors.initials: A
authors.lastname: Hellström
mesh_terms: D000465:Algorithms; D001724:Birth Weight; D005189:False Positive Reactions; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D011237:Predictive Value of Tests; D015861:Retinal Neovascularization / Q000145:classification / Q000175:diagnosis*; D012171:Retinal Vessels / Q000473:pathology*; D012178:Retinopathy of Prematurity / Q000145:classification / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015430:Weight Gain