The accuracy of digital imaging in diagnosis of retinopathy of prematurity in Iran: A pilot study

Abstract

Purpose: To evaluate sensitivity and specificity of digital retinal image reading in the diagnosis of referral-warranted retinopathy of prematurity (ROP). Methods: Infants referred to the ROP clinic underwent fundus examination through indirect ophthalmoscopy. Fundus photographs were acquired using RetCam (shuttle 2; Clarity medical systems, Pleasanton, CA, USA). Four retinal specialists who were blind to patients’ information reviewed the RetCam fundus photographs. By comparing the results of photographs’ readings with that of indirect ophthalmoscopy as the gold standard, the sensitivity and specificity of telescreening was determined. Results: A total of 147 treatment-naïve patients met the inclusion criteria and were enrolled in the study. Mean gestational age (GA) was 28.6 ± 2.0 weeks. Digital retinal imaging had sensitivity of 85% and specificity of 35% in detecting referral-warranted ROP in our study. Positive predictive value of digital photography was 80%, and negative predictive value was 43%. Conclusion: Digital photography for diagnosis of ROP may show good potential as a screening modality in developing countries. It can facilitate early diagnosis, prevent unnecessary referrals, and be implemented for investigational purpose. However, the overall study result did not provide evidence to propose digital photography as a substitute for indirect ophthalmoscopy in the diagnosis of ROP.

Latest Trends in Retinopathy of Prematurity: Research on Risk Factors, Diagnostic Methods and Therapies

“…62,63 ROP screening is performed by a pediatric ophthalmologist or retina specialist through indirect binocular ophthalmoscopy along with concomitant scleral indentation for the assessment of retinal periphery. 64 65 RetCam is a wide-angle computerized retinal imaging system that is commonly used in developed countries to examine preterm infants at risk of developing ROP. 66 When it comes to diagnosing and monitoring ROP, the ability to store the images obtained and the possibility to dynamically compare the evolution of a patient are one of the important advantages of RetCam.…”

Cámara retiniana infantil (retinógrafo) de campo amplio con angiografía fluoresceínica para el cribado, diagnóstico y seguimiento de la Retinopatía de la Prematuridad

“…Se han publicado estudios que muestran el uso de RetCam sin la AF, pero muestran limitaciones importantes de concordancia en la interpretación de imágenes entre los profesionales expertos y los profesionales en formación 25 , e incluso entre expertos, se presentan también problemas de precisión diagnóstica [30][31][32] .…”