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Evaluating a Portable, Noncontact Fundus Camera for Retinopathy of Prematurity Screening by Nonophthalmologist Health Care Workers.

Publication ,  Journal Article
Prakalapakorn, SG; Freedman, SF; Hutchinson, AK; Wallace, DK; Stinnett, SS; Riggins, JW; Gallaher, KJ
Published in: Ophthalmol Retina
August 2018

PURPOSE: To evaluate (1) the feasibility of non-ophthalmologist healthcare workers (HCWs) to obtain images of sufficient quality for retinopathy of prematurity (ROP) screening using a FDA-approved portable, non-contact, narrow-field fundus camera (i.e., Pictor™), and (2) the accuracy of grading these images to identify infants who developed treatment-warranted (type 1) ROP. DESIGN: Prospective cohort study. SUBJECTS: Infants undergoing routine ROP screening examinations (i.e. birth weight ≤1500 grams and/or gestational age ≤30 weeks or selected infants with a birth weight of 1500-2000g or gestational age >30 weeks and an unstable clinical course). METHODS: We prospectively recruited infants undergoing ROP screening examinations at a community hospital. On the same day an ophthalmologist examined them, a trained HCW imaged their retinas using the non-contact camera. Two masked ROP experts graded these images remotely. We calculated both the percentage of gradable images (i.e. having at least 3 quadrants with sufficient image quality), as well as the accuracy of identifying infants who developed type 1 ROP. MAIN OUTCOME MEASURES: Percentage of gradable images and the sensitivity and specificity of each grader for identifying infants with type 1 ROP by grading for the presence of pre-plus or plus disease. RESULTS: Ninety-nine infants were included. Overall, 92.4% and 94.2% of all infant imaging sessions were considered gradable by graders 1 and 2, respectively. Amongst gradable images, the sensitivity of both graders for identifying type 1 ROP by grading for the presence of pre-plus or plus disease was 100% (95% confidence interval (CI): 95-100%) and the specificity 91% (95% CI: 83-95%) for grader 1 and 93% (95% CI: 86-96%) for grader 2. CONCLUSIONS: It was highly feasible for trained HCWs to obtain digital retinal images of sufficient quality for ROP screening using a non-contact fundus camera. By grading for the presence of pre-plus or plus disease, graders identified infants who developed type 1 ROP with high sensitivity and specificity. The use of portable, non-contact retinal cameras by trained HCWs could increase our workforce in ROP screening and identify infants needing an indirect ophthalmoscopy examination by an ophthalmologist.

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Published In

Ophthalmol Retina

DOI

ISSN

2468-7219

Publication Date

August 2018

Volume

2

Issue

8

Start / End Page

864 / 871

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Prakalapakorn, S. G., Freedman, S. F., Hutchinson, A. K., Wallace, D. K., Stinnett, S. S., Riggins, J. W., & Gallaher, K. J. (2018). Evaluating a Portable, Noncontact Fundus Camera for Retinopathy of Prematurity Screening by Nonophthalmologist Health Care Workers. Ophthalmol Retina, 2(8), 864–871. https://doi.org/10.1016/j.oret.2017.12.003
Prakalapakorn, S Grace, Sharon F. Freedman, Amy K. Hutchinson, David K. Wallace, Sandra S. Stinnett, J Wayne Riggins, and Keith J. Gallaher. “Evaluating a Portable, Noncontact Fundus Camera for Retinopathy of Prematurity Screening by Nonophthalmologist Health Care Workers.Ophthalmol Retina 2, no. 8 (August 2018): 864–71. https://doi.org/10.1016/j.oret.2017.12.003.
Prakalapakorn SG, Freedman SF, Hutchinson AK, Wallace DK, Stinnett SS, Riggins JW, et al. Evaluating a Portable, Noncontact Fundus Camera for Retinopathy of Prematurity Screening by Nonophthalmologist Health Care Workers. Ophthalmol Retina. 2018 Aug;2(8):864–71.
Prakalapakorn, S. Grace, et al. “Evaluating a Portable, Noncontact Fundus Camera for Retinopathy of Prematurity Screening by Nonophthalmologist Health Care Workers.Ophthalmol Retina, vol. 2, no. 8, Aug. 2018, pp. 864–71. Pubmed, doi:10.1016/j.oret.2017.12.003.
Prakalapakorn SG, Freedman SF, Hutchinson AK, Wallace DK, Stinnett SS, Riggins JW, Gallaher KJ. Evaluating a Portable, Noncontact Fundus Camera for Retinopathy of Prematurity Screening by Nonophthalmologist Health Care Workers. Ophthalmol Retina. 2018 Aug;2(8):864–871.

Published In

Ophthalmol Retina

DOI

ISSN

2468-7219

Publication Date

August 2018

Volume

2

Issue

8

Start / End Page

864 / 871

Location

United States