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Original research
Identification of treatment-warranted retinopathy of prematurity by neonatal nurse specialist
  1. Janette Ravelo1,
  2. Gillian Adams2,
  3. Shahid Husain1,3
  1. 1 Neonatology Department, Homerton University Hospital NHS Foundation Trust, London, UK
  2. 2 Strabismus and Paediatric Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  3. 3 Genetics and Child Health, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
  1. Correspondence to Dr Shahid Husain, Genetics and Child Health, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK; s.m.husain{at}qmul.ac.uk

Abstract

Objective To determine the accuracy in the identification of infants with treatment-warranted retinopathy of prematurity (ROP) by a trained and experienced ROP neonatal nurse specialist compared with skilled ophthalmologists.

Methods A single-centre, prospective, blinded, agreement study was performed on a cohort of infants undergoing ROP screening. An experienced ROP neonatal nurse specialist obtained retinal images using a wide field digital retinal imaging system (WFDRI) on 127 infants and identified those with treatment-warranted ROP. This interpretation was compared with the interpretation of the same images by skilled ophthalmologists. The accuracy of the ROP nurse specialist’s interpretation was assessed for sensitivity and specificity compared with the gold standard interpretation by the ophthalmologists.

Results The ROP nurse specialist performed 345 ROP screens on both eyes of 127 infants. The mean (SD) gestation age (weeks) and birth weight (g) of the infants screened was 26.8 (2.8) and 929 (327), respectively. The nurse specialist correctly identified all 8 infants with treatment-warranted ROP and 118/119 infants without. The sensitivity and specificity (95% CI) of ROP screening episodes were 100% (63% to 100%) and 99.7% (98.4% to 100.0%), respectively.

Conclusion A trained and experienced ROP neonatal nurse specialist can correctly identify infants with treatment-warranted ROP using WFDRI. Further work is required to examine the generalisability of this finding and its impact on ROP screening services.

  • neonatology
  • nursing
  • ophthalmology

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Deidentified participant data are available from the corresponding author.

https://doi.org/10.1136/archdischild-2021-322266

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information. Deidentified participant data are available from the corresponding author.

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    Footnotes

    • Contributors GA and SH conceived the idea for this project and developed the methodology. GA and JR collected data that were analysed by SH. JR wrote the first draft of the manuscript which was revised by GA and SH.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.