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Sasapin Prakalapakorn, David Wallace, Sharon Freedman; Evaluation of a portable, non-contact digital fundus camera (Pictor) in premature infants. Invest. Ophthalmol. Vis. Sci. 2013;54(15):620.
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To evaluate the feasibility of using a new portable, non-contact digital fundus camera, Pictor (Volk Optical Inc., Mentor, OH), to obtain high-quality images of the retina of premature infants.
We retrospectively reviewed digital Pictor images taken of infants during routine examinations for Retinopathy of Prematurity (ROP) in the Duke Hospital Intensive Care Nursery over a 6-month period. Infants were included if they had at least one color and one red-free photograph taken of each eye that included an image of the optic nerve. The color and red-free images were obtained simultaneously. Up to 3 images were included for each eye. For each eye, the image with the greatest field of view was quantified in disc diameters (DD), using the average DD measured from the same image. Two ROP experts reviewed the color and red-free images independently and evaluated them for (1) quality (good, fair or poor) based on the ability to determine the dilation and/or tortuosity of the vessels in the image and (2) number of gradable quadrants (0 to 4), based on the adequate visibility of ≥1 DD length of a major vessel in a given quadrant.
There were 96 eyes of 48 infants [mean gestational age 27 weeks (range 23-34), birth weight 872 grams (420-1480), post-menstrual age at examination 38 weeks (31-47)]. The mean field of view for all eyes was 5.0 DD x 6.1 DD. Grader 1 and Grader 2 found image quality to be good or fair in 96% and 97% of images, respectively. Grader 1 and Grader 2 judged images as having at least 3 gradable quadrants in 80% and 86% of images, respectively.
The Pictor camera is able to capture digital retinal images of premature infants that are of good quality and that usually have at least 3 gradable quadrants. The Pictor camera may be a valuable tool for ROP screening. Future studies will evaluate the accuracy of grading pre-plus and plus disease using Pictor fundus images.
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