June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Telemedical Diagnosis of Stage 4 and Stage 5 Retinopathy of Prematurity
Author Affiliations & Notes
  • Robison Vernon Paul Chan
    Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, United States
    Center for Global Health, University of Illinois at Chicago, Chicago, Illinois, United States
  • Samir N Patel
    Ophthalmology, Memorial Sloan Kettering Cancer Center, New York, New York, United States
  • Ranjodh Singh
    Weill Cornell Medical College, New York, New York, United States
  • Karyn Elizabeth Jonas
    Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, United States
  • Susan Ostmo
    Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
  • Mrinali P. Gupta
    Ophthalmology, Weill Cornell Medical College, New York, New York, United States
  • J. Peter Campbell
    Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
  • Michael F Chiang
    Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Robison Chan, Alcon (C), Allergan (C), Bausch and Lomb (C), Visunex Medical Systems (C); Samir Patel, None; Ranjodh Singh, None; Karyn Jonas, None; Susan Ostmo, None; Mrinali Gupta, None; J. Peter Campbell, None; Michael Chiang, Clarity (S), Novartic (C)
  • Footnotes
    Support  NIH EY19474 (SO, KEJ, RVPC, MFC), NIH P30 EY010572 (JPC, SO, MFC); NIH R21 EY22387 (MFC); unrestricted departmental funding from Research to Prevent Blindness, New York, NY (SNP, MPG, JPC, RS, SO, KEJ, RVPC, MFC); Grant 1622679 from the National Science Foundation (Arlington, VA); and the iNsight Foundation (RVPC, KEJ)
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5524. doi:
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      Robison Vernon Paul Chan, Samir N Patel, Ranjodh Singh, Karyn Elizabeth Jonas, Susan Ostmo, Mrinali P. Gupta, J. Peter Campbell, Michael F Chiang; Telemedical Diagnosis of Stage 4 and Stage 5 Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5524.

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

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Abstract

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

Methods : This is a prospective cohort study. 1220 eye examinations from 230 infants were prospectively obtained from 8 major ROP centers. 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, which were independently read by two ROP experts using a web-based system for an image-based diagnosis. Sensitivity and specificity of image-based diagnosis from the ROP experts were calculated using the clinical diagnosis as the reference standard.

Results : 28/1220 (2%) eye examinations had a clinical diagnosis of stage 4 or worse disease. Among these 28 examinations, expert 1 had a 21/28 (75%) agreement with the clinical diagnosis, and for the 7 discrepancies, the expert provided a diagnosis of stage 0 in 5 eye examinations and stage 3 in 2 eye examinations. Among the 28 eye examinations with a clinical diagnosis of stage 4 or worse disease, expert 2 had agreement in 24/28 (85%) eye examinations, and for the 4 discrepancies, the expert provided a diagnosis of stage 0 in 4 eye examinations. Using the clinical diagnosis as the reference standard, for the image based detection of stage 4 or worse disease, experts 1 and 2 had a sensitivity of 75% and 86%, respectively. For the image based detection of stage 5 disease, both experts 1 and 2 had a sensitivity of 69%.

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

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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