We have done extensive laboratory work showing that insulin like growth factor 1 (IGF-1) which mediates growth is a major factor in the development of ROP (Hellström A et al Proceedings of the National Academy of Sciences, 2001).
Based on that finding we developed and published an algorithm WINROP® based on serial neonatal measurements of body weight, which predicts ROP development. The original article including IGF measurements prompted an editorial in Archives of Ophthalmology “Screening for Retinopathy of Prematurity- The Promise of New Approaches”.
The algorithm has now been further developed (web based, free of charge) and validated retrospectively on 50 children screened for ROP 2005-2007 at various Swedish neonathal wards in, Sweden. We found that WINROP® predicted early (mean 9 weeks before ROP needing treatment was detected by present screening routines) all infants who later developed proliferative ROP requiring treatment (sensitivity 100% and specificity 54%) (Löfqvist C et al Archives Ophthalmol 2009). In order to make WINROP® rapid and robust as well as more equipment-free we have revised the algorithm using only serial weight measurements. With this approach WINROP® predicted early all infants who later developed proliferative ROP requiring treatment and correctly identified 75% of those who did not develop proliferative ROP (Hellström A et al Pediatrics 2009), and thus would not need any ophthalmologic screening. In addition, we have validated WINROP® in a preterm population in Boston (n=375) indicating a 100% sensitivity and a 76% specificity (Wu C et al Archives Ophthalmol 2009). Applying these figures of reduced screening to the European preterm population the number of ophthalmological examinations could be safely reduced by 200,000 examinations/year, yet include 100% of infants requiring treatment for ROP. WINROP® has been further validatet in multiple clinical settings international, see PUB Med for scientific publications.
In order to establish this as the new standard of care worldwide WINROP® is now validated in Sweden, Northamerica, Great Britain, Germany, Schwitzerland, Mexico, China, Southkorea, Netherlands, India, Scotland, Canada and Brasil. WINROP® is now up and running in 47 countries, used by 266 caregivers (2016). The use of WINROP® for screening would identify early children at risk and could lead to early interventions. Globally health personnel could focus on the right patients at the right time. Thus, WINROP® (simple to perform with minimal training) would supply a descision making tool in ROP screening -an approach that is clearly cost effective and makes better use of resources.