Author’s Disclosure Block: Felicia Tai, none; Yasmin Jindani, none; Kourosh Sabri, none

Abstract Body
Purpose: Retinopathy of prematurity (ROP) is a proliferative retinal vascular disease affecting many premature infants, with 5-10% of untreated ROP leading to permanent blindness. Many models currently exist for screening premature infants for treatment-requiring ROP. In Canada, the current recommendation is to screen infants with gestational age (GA) <31 weeks or birth weight (BW) <1,251g.Reducing unnecessary retinopathy of prematurity (ROP) screenings in neonates is important for minimizing morbidity associated with painful screenings, anxiety in parents, and conserving healthcare resources and costs. The Seminal Canadian Recommendations for Evidence-Based Examination of Neonates for Retinopathy of Prematurity (SCREEN-ROP) is a nationwide study published in 2020 which examined various prenatal and postnatal predictors of developing ROP requiring treatment. SCREEN-ROP recommends only screening babies born with BW <1200g or GA <30 weeks to prevent unnecessary screenings.This study aims to retrospectively test the sensitivity of SCREEN-ROP in an urban Canadian setting in capturing all babies requiring treatment for ROP. Study Design: Retrospective single-center cohort study Methods: All babies born at the McMaster Children Hospital from July 1, 2016 to May 31, 2024 who met the following criteria were include: 1) received at least one ROP eye exam, or 2) received ROP treatment. Birth weight (BW) and gestational age (GA) was collected from Canadian Neonatal Network (CNN) and BORN Ontario, which stores all information on babies admitted to level 3 and level 2 NICUs, respectively. Institutional ethics was obtained from Hamilton Integrated Research Ethics Board (REB #13216-C) and CNN (REB #04-062). SCREEN-ROP criteria were retroactively applied to the cohort. Sensitivity and specificity of the model was calculated with 95% confidence intervals. Chi-squared test was used to compare the babies captured with SCREEN-ROP criteria. Results: 823 unique babies were screened from July 1, 2016 to May 31, 2024. Of 79 unique babies were treated for ROP, none were missed with SCREEN-ROP criteria. 61 babies (7.41%) would not have required screening with SCREEN-ROP criteria. Sensitivity of SCREEN-ROP criteria for capturing babies requiring ROP treatment was 100% (95% CI: 95.44% to 100%), and specificity of 8.20% (95% CI: 6.33% to 10.41%). Conclusion: By screening babies with BW <1200g or GA <30 weeks, 7.41% of babies would have been saved from unnecessary ROP screenings, and all babies requiring ROP treatment would have been captured with 100% sensitivity. Further validation in larger and more diverse populations are needed prior to broad implementation of SCREEN-ROP.