Real-time, computer-assisted quantification of plus disease in retinopathy of prematurity at the bedside.
BACKGROUND AND OBJECTIVE: Plus disease is the primary indication for retinopathy of prematurity (ROP) treatment, but in borderline cases ophthalmologists may struggle to judge whether it is present. ROPtool is a semi-automated computer program that objectively assesses plus disease by measuring retinal vascular tortuosity and width. This study determined ROPtool's bedside diagnostic accuracy concurrent with ROP screening. PATIENTS AND METHODS: ROP screening examinations were recorded using Keeler video indirect ophthalmoscopy. A masked operator traced images in ROPtool at the bedside, comparing ROPtool's plus diagnosis to the examiner's clinical judgment. RESULTS: Four hundred sixty-four examinations (129 eyes of 65 infants) were performed. ROPtool's sensitivity, specificity, and area under the receiver operating characteristic curve for plus diagnosis was 71% (CI: 38%-100%), 93% (CI: 89%-98%) and 0.87, and for pre-plus or worse was 68% (CI: 51%-85%), 82% (CI: 77%-86%) and 0.81, respectively. CONCLUSION: ROPtool can provide a real-time second opinion of plus disease at the bedside. Image enhancement technologies may further improve ROPtool's diagnostic accuracy.
Duke Scholars
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Related Subject Headings
- Sensitivity and Specificity
- Retinopathy of Prematurity
- Retinal Vessels
- Reproducibility of Results
- ROC Curve
- Point-of-Care Systems
- Ophthalmoscopy
- Male
- Intensive Care Units, Neonatal
- Infant, Very Low Birth Weight
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Sensitivity and Specificity
- Retinopathy of Prematurity
- Retinal Vessels
- Reproducibility of Results
- ROC Curve
- Point-of-Care Systems
- Ophthalmoscopy
- Male
- Intensive Care Units, Neonatal
- Infant, Very Low Birth Weight