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Multicenter Study
. 2018 Jan;2(1):59-64.
doi: 10.1016/j.oret.2017.04.001. Epub 2017 Jun 9.

Telemedical Diagnosis of Stage 4 and Stage 5 Retinopathy of Prematurity

Samir N Patel  1 , Ranjodh Singh  1 , Karyn E Jonas  2 , Susan Ostmo  3 , Mrinali P Gupta  1 , J Peter Campbell  3 , Michael F Chiang  4 , R V Paul Chan  5 ; Imaging and Informatics for Retinopathy of Prematurity Research Consortium
Collaborators, Affiliations
Multicenter Study

Telemedical Diagnosis of Stage 4 and Stage 5 Retinopathy of Prematurity

Samir N Patel et al. Ophthalmol Retina. 2018 Jan.

Abstract

Purpose: To determine the accuracy of image-based diagnosis for stage 4 or worse retinopathy of prematurity (ROP) disease.

Design: Prospective cohort study.

Participants: We prospectively obtained data, from 8 major ROP centers, for 1220 eye examinations from 230 infants.

Methods: An ophthalmologist at each center provided a clinical diagnosis using indirect ophthalmoscopy. Wide-angle retinal images (RetCam; Clarity Medical Systems, Pleasanton, CA) were then obtained, and these were independently read by 2 ROP experts using a web-based system for an image-based diagnosis.

Main outcome measures: Sensitivity and specificity of image-based diagnosis from the ROP experts were calculated using the clinical diagnosis as the reference standard.

Results: Of 1220 examinations, 28 (2%) had a clinical diagnosis of stage 4 or worse. Sensitivity and specificity for stage 4 or worse disease were 75% and 99% for expert 1, and 86% and 99% for expert 2. Sensitivity and specificity for the detection of stage 5 disease were 69% and 99% for both experts.

Conclusions: There are inconsistencies in the accuracy of image-based diagnosis of stage 4 and stage 5 ROP when compared with the clinical diagnosis.

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Figures

Figure 1.
Figure 1.
Eye examinations with diagnostic discrepancies between the clinical retinopathy of prematurity (ROP) diagnosis and image-based ROP diagnosis. A, Clinical diagnosis of stage 4 disease. Expert 1 provided an image-based diagnosis of stage 3, and expert 2 provided an image-based diagnosis of stage 4. The reason for the diagnostic discrepancy was difficulty in appreciating traction and elevation of the retina. B, Clinical diagnosis of stage 4 disease. Expert 1 provided an image-based diagnosis of stage 4, and expert 2 provided an image-based diagnosis of stage 0. The reason for the diagnostic discrepancy was hazy media. C, Clinical diagnosis of stage 5 disease. Both expert 1 and expert 2 provided an image-based diagnosis of stage 4. The reasons for the diagnostic discrepancy were hazy media and insufficient retinal coverage.
See this image and copyright information in PMC

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