Children's Hospital of Philadelphia Score to predict severe retinopathy in Indian preterm infants

Abstract

Background: Retinopathy of Prematurity (ROP) screenings are expensive and entail heavy workload. Predictive models using postnatal weight gain reduces the number of ophthalmological examinations. The objective was to validate Children's Hospital of Philadelphia (CHOP) score to predict severe ROP in resource limited settings.

Methods: Prior to ophthalmic examination, the CHOP score was calculated to predict severe ROP (point estimate = 0.014) in 191 preterm infants. Cut-off point estimate, most suitable in resource limited settings was assessed.

Results: CHOP Score cutoff point (0.014) showed 67% sensitivity, 75% specificity. With CHOP score cut-off point (0.010), the corresponding values were 100% sensitivity, 51% specificity, PPV 12% and NPV 100%.

Conclusion: CHOP Score (0.014) is a poor tool to predict the onset of severe ROP. However, CHOP Score (0.010) is a promising tool to predict the onset of severe ROP and reduces the need for ophthalmological examinations by 50% in resource limited settings.

Fig. 1

Sample nomogram to predict the risk of severe ROP based on the CHOP ROP model. A straight line is drawn between the values for birth weight and daily rate of weight gain. The intersection of this line with the gray auxiliary axis is then connected to the value for GA. The intersection of this second line with the probability line provides the predicted probability of severe ROP. If the risk is greater than 0.014, eye examinations are indicated. (From Binenbaum G, Ying GS, Quinn GE, et al. The CHOP postnatal weight gain, birth weight, and gestational age retinopathy of prematurity risk model. Arch Ophthalmol 2012;130(12):1560–5; with permission.)