Structural Equation Modelling of Retinopathy of Prematurity Treatment Integrating Both Physical and Clinical Effects García-Serrano, José Luis Protsyk, Olena Domech Serrano, Teresa Uberos Fernández, José retinopathy of prematurity therapy structural equation models Background: We sought to develop a structural equation model (SEM) identifying physical and clinical risk factors associated with treatment for retinopathy of prematurity (ROP). Methods: This retrospective, observational, case–control study included 314 infants screened for ROP between April 2004 and July 2024. A bivariate binary logistic regression model, decision tree, and structural equation model (SEM) were employed to develop a more general model for ROP requiring treatment. Results: In the SEM, the factors significantly associated with ROP treatment included the retinal avascular area according to disk diameter (DD) (p < 0.001), weekly vascularisation rate (DD/w) (p < 0.001), and duration of intubation (days) (p < 0.001). In addition, the following significant associations were identified in both the bivariate analysis and the SEM: lower gestational age (p < 0.001) and birth weight (p <0.001) were associated with greater retinal avascular area; low postnatal weight gain (p < 0.027) was associated with a slow rate of retinal vascularisation; sepsis (p < 0.001), ductus arteriosus (p < 0.001), and the need for transfusion (p < 0.001) were associated with longer intubation mechanical ventilation (IMV). Conclusions: Lower gestational age, lower birth weight, sepsis, ductus arteriosus, transfusion, and lower weight gain increase the risk of requiring ROP treatment. In the SEM, this association is represented through three intermediate physical endogenous variables, namely, the greater temporal avascular area of the retina, the lower postnatal vascularisation rate, and the greater duration of IMV. 2025-01-07T12:03:15Z 2025-01-07T12:03:15Z 2025-01-07 journal article García Serrano, J.L. et. al. J. Clin. Med. 2025, 14, 297 [https://doi.org/10.3390/jcm14020297] https://hdl.handle.net/10481/98518 10.3390/jcm14020297 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional MDPI