Accuracy of retinopathy of prematurity diagnosis by retinal fellows
- PMID: 20168274
- PMCID: PMC2884082
- DOI: 10.1097/IAE.0b013e3181c9696a
Accuracy of retinopathy of prematurity diagnosis by retinal fellows
Abstract
Purpose: The purpose of this study was to measure the accuracy of retinopathy of prematurity (ROP) diagnosis by retinal fellows.
Methods: An atlas of 804 retinal images was captured from 248 eyes of 67 premature infants with a wide-angle camera (RetCam-II, Clarity Medical Systems, Pleasanton, CA). Images were uploaded to a study Web site, from which an expert pediatric retinal specialist and 7 retinal fellows independently provided a diagnosis (no ROP, mild ROP, type 2 ROP, or treatment-requiring ROP) for each eye. The sensitivity and specificity of each retinal fellow were calculated and subsequently compared with a reference standard of diagnosis by an expert pediatric retinal specialist.
Results: For detection of type 2 or worse ROP by fellows, mean (range) sensitivity was 0.751 (0.512-0.953), and specificity was 0.841 (0.707-0.976). For detection of treatment-requiring ROP, mean (range) sensitivity was 0.914 (0.667-1.000), and specificity was 0.871 (0.678-0.987).
Conclusion: In general, fellows showed high accuracy for detecting ROP. However, 3 of 7 fellows achieved <80% sensitivity for diagnosis of type 2 or worse ROP, and 2 of 7 achieved <90% sensitivity for diagnosis of treatment-requiring ROP. This could lead to undermanagement and undertreatment of clinically significant disease and raises potential concerns about the quality of ROP screening examinations performed by less-experienced examiners.
Figures







Similar articles
-
Accuracy of retinopathy of prematurity image-based diagnosis by pediatric ophthalmology fellows: implications for training.J AAPOS. 2011 Dec;15(6):573-8. doi: 10.1016/j.jaapos.2011.06.011. J AAPOS. 2011. PMID: 22153403 Free PMC article.
-
Telemedical diagnosis of retinopathy of prematurity: accuracy of expert versus non-expert graders.Br J Ophthalmol. 2010 Mar;94(3):351-6. doi: 10.1136/bjo.2009.166348. Epub 2009 Dec 2. Br J Ophthalmol. 2010. PMID: 19955195 Free PMC article.
-
Diagnostic Discrepancies in Retinopathy of Prematurity Classification.Ophthalmology. 2016 Aug;123(8):1795-1801. doi: 10.1016/j.ophtha.2016.04.035. Epub 2016 May 27. Ophthalmology. 2016. PMID: 27238376 Free PMC article.
-
Accuracy and reliability of remote retinopathy of prematurity diagnosis.Arch Ophthalmol. 2006 Mar;124(3):322-7. doi: 10.1001/archopht.124.3.322. Arch Ophthalmol. 2006. PMID: 16534051
-
Validated System for Centralized Grading of Retinopathy of Prematurity: Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) Study.JAMA Ophthalmol. 2015 Jun;133(6):675-82. doi: 10.1001/jamaophthalmol.2015.0460. JAMA Ophthalmol. 2015. PMID: 25811772 Free PMC article.
Cited by
-
An international comparison of retinopathy of prematurity grading performance within the Benefits of Oxygen Saturation Targeting II trials.Eye (Lond). 2018 Jan;32(1):74-80. doi: 10.1038/eye.2017.150. Epub 2017 Jul 28. Eye (Lond). 2018. PMID: 28752837 Free PMC article. Clinical Trial.
-
Plus disease in retinopathy of prematurity: qualitative analysis of diagnostic process by experts.JAMA Ophthalmol. 2013 Aug;131(8):1026-32. doi: 10.1001/jamaophthalmol.2013.135. JAMA Ophthalmol. 2013. PMID: 23702696 Free PMC article.
-
Implementation and evaluation of a tele-education system for the diagnosis of ophthalmic disease by international trainees.AMIA Annu Symp Proc. 2015 Nov 5;2015:366-75. eCollection 2015. AMIA Annu Symp Proc. 2015. PMID: 26958168 Free PMC article.
-
Retinopathy of prematurity residency training.Ophthalmology. 2012 Dec;119(12):2644-5.e1-2. doi: 10.1016/j.ophtha.2012.07.015. Ophthalmology. 2012. PMID: 23207022 Free PMC article. No abstract available.
-
Artificial Intelligence in Retinopathy of Prematurity Diagnosis.Transl Vis Sci Technol. 2020 Feb 10;9(2):5. doi: 10.1167/tvst.9.2.5. Transl Vis Sci Technol. 2020. PMID: 32704411 Free PMC article. Review.
References
-
- Flynn JT, Bancalari E, Bachynski BN, et al. Retinopathy of prematurity. Diagnosis, severity, and natural history. Ophthalmology. 1987;94:620–629. - PubMed
-
- Martin JA, Hamilton BE, Sutton PD, et al. Births: final data for 2005. Natl Vital Stat Rep. 2007;56:1–103. - PubMed
-
- National Eye Institute Retinopathy of Prematurity. [Accessed May 16, 2008]. Available at: http://www.nei.nih.gov/health/rop/.
-
- Phelps DL. Retinopathy of prematurity: an estimate of vision loss in the United State—1979. Pediatrics. 1981;67:924–925. - PubMed
-
- Multicenter trial of cryotherapy for retinopathy of prematurity. Preliminary results. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Arch Ophthalmol. 1988;106:471–479. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources