September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Inter-Eye Agreement of ROP Features in Image Evaluation in the Telemedicine Approaches to Evaluating of Acute-Phase ROP (e-ROP) Study
Author Affiliations & Notes
  • Wei Pan
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Gui-Shuang Ying
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Graham E Quinn
    Ophthalmology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Ebenezer Daniel
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Agnieshka Baumritter
    Ophthalmology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Wei Pan, None; Gui-Shuang Ying, None; Graham Quinn, None; Ebenezer Daniel, None; Agnieshka Baumritter, None
  • Footnotes
    Support  U10EY017014, R21EY025686
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6271. doi:
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      Wei Pan, Gui-Shuang Ying, Graham E Quinn, Ebenezer Daniel, Agnieshka Baumritter; Inter-Eye Agreement of ROP Features in Image Evaluation in the Telemedicine Approaches to Evaluating of Acute-Phase ROP (e-ROP) Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6271.

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

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Abstract

Purpose : To determine the symmetry of ROP features (stage, zone and plus disease) between paired eyes in the image evaluation of retinal images of premature infants.

Methods : Secondary analysis of data from image evaluation in e-ROP. Infants with birth weight less than 1251g underwent a series of retinal imaging sessions in both eyes by non-physician certified imagers using the Retcam Shuttle paired with a diagnostic eye examination by certified ophthalmologists starting at 32 weeks of postmenstrual age (PMA). Two trained readers graded independently ROP characteristics in a 5-image set from each eye. At the image reading center, readers were masked to diagnostic examination results, previous grading results, the current grading results of the fellow eye, and demographic data. A reading supervisor adjudicated disagreement between readers. The inter-eye agreements of ROP features were assessed using percent of agreement and weighted kappa.

Results : Among 1235 infants with images taken in both eyes at a session (total of 3918 image sessions), the percent of exact agreement (weighted kappa) was 75.3% (0.65) for stage of ROP (no ROP, stages 1 or 2, 3 or above, cannot grade), 78.7% (0.51) for preplus/plus disease (normal, preplus, plus, cannot grade), and 82.3% (0.68) for zone of ROP (no ROP, zone I, zone II, cannot grade), 84.7% (0.56) for RW-ROP (no, yes, cannot grade), and 72.7% (0.63) for type of ROP (no ROP, mild ROP, type 2, type 1, cannot grade). Similar inter-eye agreements were found in the first image session, the last image session and PMA weeks. Based on image evaluations at all sessions, 412 (33.4%) infants had ROP stage 3 or above at some point, 70 (5.7%) had plus disease, 148 (12.0%) had zone I ROP and 419 (33.9%) had RW-ROP; the percent of presence of these features in both eyes at some point was 71.4% for ROP stage 3 or above, 50.0% for plus disease, 56.8% for Zone I ROP and 73.7% for RW-ROP.

Conclusions : The masked image evaluations by trained readers showed good inter-eye agreement in ROP characteristics, consistent with the high inter-eye correlation in ROP from clinical examinations by ophthalmologist. This finding supports the utility of using images in the clinical management and research of ROP.

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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