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D.H. Kauffmann Jokl, A.D. Springer, R.H. Silverman, S. Kane, H. Towers, H.O. Lloyd, I. Barbazetto, R. Horowitz, O. Vidne, R. Lopez; Ultrasonic Evaluation of Retinopathy of Prematurity . Invest. Ophthalmol. Vis. Sci. 2003;44(13):584.
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Purpose: Currently, detection for retinopathy of prematurity (ROP) is limited to indirect ophthalmoscopy requiring considerable skill and experience by the examiner. We tested whether 10 MHz B-scan ultrasonography could document the clinical stages of ROP as accurately as indirect ophthalmoscopy. Methods: Neonates were examined by masked, independent observers with indirect ophthalmoscopy and B-scan 10MHz ultrasonography. The retinologist recorded the stage of retinopathy with a retinal drawing. The ultrasonographer determined the presence of absence of a ridge or tractional elements, if present, on the ridge. The findings were compiled for statistical analysis, which were compared and the correlation coefficient was determined. Results: We examined 34 eyes on 19 neonates. Ultrasonographic stages were in agreement with ophthalmoscopic findings in 21 of 34 eyes. In 17 eyes, ultrasound grade was one stage higher than clinical grade, and in 8 eye it was 2 stages higher. One stage 1 eye was misclassified as stage 4 due to presence of ultrasound artifacts. Ultrasound grade was correlated with clinical grade (R=.81, p<.001). Conclusions: Our findings demonstrate that 10 MHz ultrasonography offers the potential of imaging and detecting the clinical stages of ROP. The use of higher ultrasound frequencies, now becoming commercially available, is likely to enhance diagnostic accuracy. ROP suspects could be screened with B-scan ultrasonography by neonatal personnel, without the need for pupillary dilatation, and clinically significant cases could then be referred to the retinologist.
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