Local Validation of G-ROP and Modified G-ROP Criteria in the Detection of Prethreshold Retinopathy of Prematurity

‎Objective: This study determined the diagnostic accuracies of Growth and Retinopathy of Prematurity (GROP) criteria and a novel modified G-ROP criteria on identifying retinopathy of prematurity (ROP) in infants referred for screening at a tertiary hospital. Methods: This was a single-center, cross-sectional, retrospective study. Medical records of infants referred for ROP screening from January 2012 to December 2021 were reviewed. Infants were labelled as “requiring ROP examination” if they met the 2020 Philippine Academy of Ophthalmology – ROP Working Group (PAOROPWG) screening consensus, G-ROP, or modified G-ROP criteria. We compared the accuracy of each criterion in predicting prethreshold ROP, evaluating sensitivity, specificity, and predictive values, as well as percentage of low-risk infants. Statistical analysis used Chi-square tests and one-way ANOVA with post hoc testing. Results: Of the 873 infants, 162 infants (18.6%) were noted to have ROP of any stage. Type 1 ROP developed in 15.4%, and type 2 ROP in 16.7%. The 2020 PAO-ROPWG consensus had 100% sensitivity (95% CI: 86.3%- 100%) in detecting type 1 and 2 ROP while 323 infants (37%) were low-risk. G-ROP criteria had 100% (95% CI: 86.3%-100%) sensitivity and 79.2% (95% CI: 76.4%-81.9%) specificity in predicting type 1 ROP, and 88.89% (95% CI: 70.84%-97.65%) sensitivity and 79.1% (95% CI: 76.2%-81.8%) specificity in predicting type 2 ROP, while 672 infants (77%) were classified as low-risk. Modified G-ROP criteria had a 100% (95% CI: 86.3%-100%) sensitivity in predicting type 1 and 2 ROP, 54.9% (95% CI: 51.5%-58.3%) and 55.1% (95% CI: 51.7%-58.5%) specificity in predicting type 1 and type 2 ROP, respectively, while 472 infants (54%) were classified as low-risk. Conclusion: G-ROP and modified G-ROP criteria showed high sensitivity and better specificity compared to the 2020 PAO-ROPWG consensus. Their stricter criteria for gestational age and birth weight likely enhanced specificity. Further research is needed to confirm these findings in a broader population.