September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Retinal Hemorrhages in Very Low Birth Weight (VLBW) Infants in the Telemedicine Approaches to Evaluating Acute-phase Retinopathy of Prematurity (e-ROP) Study
Author Affiliations & Notes
  • Eli Smith
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Wei Pan
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Ebenezer Daniel
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Gui-Shuang Ying
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Graham E Quinn
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
    Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Eli Smith, None; Wei Pan, None; Ebenezer Daniel, None; Gui-Shuang Ying, None; Graham Quinn, None
  • Footnotes
    Support  NEI Grant U10 EY017014
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6269. doi:
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      Eli Smith, Wei Pan, Ebenezer Daniel, Gui-Shuang Ying, Graham E Quinn; Retinal Hemorrhages in Very Low Birth Weight (VLBW) Infants in the Telemedicine Approaches to Evaluating Acute-phase Retinopathy of Prematurity (e-ROP) Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6269.

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

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Abstract

Purpose : To describe the characteristics of hemorrhages in infants with BW <1251g as observed on grading of digital retinal images by two non-physician trained readers (TR).

Methods : Two certified TRs evaluated the presence, type and location of hemorrhages in the digital color fundus photographs at baseline and at follow up visits (at PMA weeks of 32 to 40) from both eyes of infants enrolled in the e-ROP study. A sample of 41 image sets in which hemorrhages were noted by the TR and/or by the ophthalmologist during a corresponding bedside exam were used to determine intra and inter grader agreement in identifying presence and type of hemorrhages.

Results : Hemorrhages were observed in 267 (22%) of 1239 infants, were unilateral (73%), dot 8.2%, blot 12.3%, flame 3.4%, pre-retinal 12.3% and vitreous 1.6%. In the majority of eyes (78%) there was only one type of hemorrhage, two types coexisted in 19%, and in 3% three or more types were observed. 41% of the hemorrhages were in zone I, 35% in zone II and 23% in both zones I and II. In zone I, hemorrhages were distributed widely: superior 45%, temporal 55%, inferior 36% and nasal 57%. In zone II hemorrhages tended to be more temporally located with superior 23%, temporal 69%, inferior 21% and nasal 30%. When hemorrhages were associated with ROP, 61% were anterior, 43% posterior and 42% atop the retinopathy. Intra-grader agreement was 67% for dot, 76% for blot, 95% for flame, 57% were pre-retinal, and 62% for vitreous hemorrhages. Inter-grader agreement was 52% for dots, 52% for blot, 100% for flame, 80% for pre-retinal, and 100% for vitreous hemorrhages.

Conclusions : Approximately a fifth of <1251g infants had intraocular hemorrhages, mostly blot and pre-retinal, and generally unilateral. They were observed both in zone I and zone II and presented mostly as a single type. There was reasonable agreement between graders in identifying the different types of hemorrhages.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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