April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
A Computerized Telemedicine System for Screening of Retinopathy of Prematurity (ROP) and Validation of ROPtool
Author Affiliations & Notes
  • Ashkan Abbey
    Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI
  • Cagri G Besirli
    Ophthalmology, University of Michigan - Kellogg Eye Center, Ann Arbor, MI
  • Paul P Lee
    Ophthalmology, University of Michigan - Kellogg Eye Center, Ann Arbor, MI
  • David C Musch
    Ophthalmology, University of Michigan - Kellogg Eye Center, Ann Arbor, MI
  • Chris Andrews
    Ophthalmology, University of Michigan - Kellogg Eye Center, Ann Arbor, MI
  • Antonio Capone
    Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI
  • Kimberly A Drenser
    Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI
  • David Keith Wallace
    Ophthalmology, Duke University, Durham, NC
  • Michael Thomas Trese
    Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI
  • Footnotes
    Commercial Relationships Ashkan Abbey, None; Cagri Besirli, None; Paul Lee, None; David Musch, None; Chris Andrews, None; Antonio Capone, Allergan (C), FocusROP (C), Retinal Solutions (C), Synergetics (C), Thrombogenics (C); Kimberly Drenser, Allergan (C), FocusROP (C), Retinal Solutions (C), Synergetics (C), Thrombogenics (C); David Wallace, Allergan (C); Michael Trese, FocusROP (C), Retinal Solutions (C), Synergetics (C), Thrombogenics (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5927. doi:
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      Ashkan Abbey, Cagri G Besirli, Paul P Lee, David C Musch, Chris Andrews, Antonio Capone, Kimberly A Drenser, David Keith Wallace, Michael Thomas Trese; A Computerized Telemedicine System for Screening of Retinopathy of Prematurity (ROP) and Validation of ROPtool. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5927.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To determine if tortuosity assessment by a computer program (ROPtool) that traces retinal blood vessels and measures their tortuosity compares favorably with remote clinical grading of plus disease via telemedicine by 3 retinopathy of prematurity (ROP) experts (MT, AC, KD).

Methods: 335 high-quality RetCam images (84 with plus disease and 251controls) of premature infants were obtained by neonatal intensive care unit nurses, and were sent electronically using the FocusROP software program to 3 ROP experts who graded vessel tortuosity (plus disease). These same images were analyzed using ROPtool, which assigns a numerical value to the level of tortuosity present in each quadrant. The maximum recorded value was then compared to the grading of the ROP experts.

Results: Using 4.906 as a minimum value for declaring Referral-Merited ROP (presence of plus disease) creates a test with 96% sensitivity and 52% specificity relative to the gold standard of ROP expert reading. The receiver operating characteristic (ROC) curve revealed an area under the curve (AUC) of 0.918. 23 images (6.9%) were not gradable by ROPtool but could be read by the doctors.

Conclusions: ROPtool was found to be highly sensitive for the detection of plus disease as compared to expert physician graders. Our discussion will demonstrate how a paradigm combining regular digital fundus imaging, remote interpretation, and use of ROPtool would ensure appropriate follow-up, minimize medical error, and reduce cost of the delivery of quality care to infants at risk for developing ROP.

Keywords: 706 retinopathy of prematurity  
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