Detection of Potentially Severe Retinopathy of Prematurity by Remote Image Grading

Abstract

IMPORTANCE-Telemedicine in retinopathy of prematurity (ROP) has the potential for delivering timely care to premature infants at risk for serious ROP. OBJECTIVE-To describe the characteristics of eyes at risk for ROP to provide insights into what types of ROP are most easily detected early by image grading. DESIGN, SETTING, AND PARTICIPANTS-Secondary analysis of eyes with referralwarranted (RW) ROP (stage 3 ROP, zone I ROP, plus disease) on diagnostic examination from the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) study was conducted from May 1, 2011, to October 31, 2013, in 1257 premature infants with birth weights less than 1251 g in 13 neonatal units in North America. Data analysis was performed between February 1, 2016, and June 5, 2017. INTERVENTIONS-Serial imaging sessions with concurrent diagnostic examinations for ROP. MAIN OUTCOMES AND MEASURES-Time of detecting RW-ROP on image evaluation compared with clinical examination.

Diagnostic accuracy of a digital fundus photographic system for detection of retinopathy of prematurity requiring treatment (ROP-RT)

“…The infants in this study had older gestational age and higher birth weight which were different from previous studies [ 2 – 4 , 6 , 7 , 9 – 14 , 16 , 17 , 19 – 22 , 37 – 44 ]. This might reflect the neonatal care system in this region and might suggest the need for ROP screening in the older gestational age and higher birth weight infants.…”

“…This study had similar results to the previous studies that supported the benefit of digital fundus photographic system to detect clinically significant ROP or ROP-RT [ 2 , 3 , 6 , 9 , 11 – 13 , 15 – 17 , 19 – 22 , 36 , 38 – 40 , 42 , 44 ] but our results had higher sensitivity, specificity, and LR+. The difference in instrumentation and images quality may contribute to these differences.…”

Ophthalmoscopy and Telemedicine in Retinopathy of Prematurity

“…Although they are not direct comparisons, these studies inform us of the complexities in accurately diagnosing the individual components of severe ROP by both methods. Quinn et al also found that a substantial number of images revealed RW-ROP earlier than the diagnostic examination. The solution, it appears, lies in making telemedicine more robust, repeatable, and reproducible in capturing both prethreshold and treatable features of ROP, such that ROP specialists are confident that they can use this information in providing optimal treatment for these infants with ROP.…”