Wide-field digital retinal imaging versus binocular indirect ophthalmoscopy for retinopathy of prematurity screening: a two-observer prospective, randomised comparison

Abstract

When used in a routine ROP screening setting, a randomised comparison of WFDRI and BIO, WFDRI showed relatively poor sensitivity in detecting mild forms of ROP in the retinal periphery. This resulted in difficulty in making decisions to discharge infants from the screening programme. Sensitivity was better for more severe forms of ROP, but at present WFDRI should be regarded as an adjunct to, rather than a replacement for, BIO in routine ROP screening.

Alternative methods for the screening of retinopathy of prematurity: binocular indirect ophthalmoscopy vs wide-field digital retinal imaging

“…If only WFDRI was used for screening, uncertainty about the end-point of screening would require a prolonged course of screening for each infant. In the study of Dhaliwal et al, 9 BIO was found to be superior to WFDRI in making decisions for discharging infants from ROP screening. They suggested that it may be more efficient to perform final discharge examination of an infant using BIO, even if WFDRI was used for earlier examinations.…”

“…Dai et al 8 screened 108 premature infants and found a sensitivity of 100% and a specificity of 97.9% in detecting infants with treatment-requiring ROP. Dhaliwal et al 9 analyzed 245 eye examinations of 81 infants. They reported that the sensitivities of WFDRI in detecting any stage of ROP, stage 3 ROP and plus disease were 60, 57, and 80%, respectively, and the specificities were 91, 98, and 98%, respectively.…”

Impact of number and quality of retinal images in a telemedicine screening program for ROP: results from the e-ROP study

“…[9][10][11][12][13][14][15][16][17] However, few have reported the quality of images obtained. Ells and colleauges 2 reported that 96% of infants had successful imaging sessions, although image quality was not specifically reported.…”

“…1,[7][8][9][10][11][12][13][14][15][16][17][18][19][20] Obtaining good quality images is an integral part of the implementation of telemedicine programs to maximize the screening sensitivity. Additionally, a full set of retinal images appears to be necessary to provide the best opportunity to detect RW-ROP.…”

Response to ‘Opaque intraocular lens implantation’

“…1 Observation of the retinal vasculature close to the nasal ora serrata is necessary to determine whether disease is in zone 2 or zone 3, 2 and this is difficult to achieve with RetCam imaging. 1 We have performed a pilot study to determine the location of the junction of Zone 2 and Zone 3 in the temporal retina of RetCam images. In a series of routine ROP screening examinations in our nursery, video indirect ophthalmoscope with scleral indentation examination of the nasal ora seratta was used to identify eyes in which ROP was located at (within 1 disc diameter), or near to (1-2 disc diameters) the junction of zone 2 and zone 3.…”