May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Retinopathy of Prematurity Management Using Single-Image vs. Multiple-Image Telemedicine Examinations
A. Lajoie; S. Koreen; L. Wang; S. A. Kane; T. C. Lee; D. J. Weissgold; A. M. Berrocal; J. T. Flynn; J. B. Starren; M. F. Chiang
Author Affiliations & Notes
  • A. Lajoie
    Columbia University College of Physicians & Surgeons, New York, New York
    Ophthalmology,
  • S. Koreen
    Columbia University College of Physicians & Surgeons, New York, New York
    Ophthalmology,
  • L. Wang
    Columbia University College of Physicians & Surgeons, New York, New York
    Ophthalmology,
  • S. A. Kane
    Columbia University College of Physicians & Surgeons, New York, New York
    Ophthalmology,
  • T. C. Lee
    Ophthalmology, Childrens Hospital Los Angeles, Los Angeles, California
  • D. J. Weissgold
    Ophthalmology, Retina Center of Vermont, Burlington, Vermont
  • A. M. Berrocal
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • J. T. Flynn
    Columbia University College of Physicians & Surgeons, New York, New York
    Ophthalmology,
  • J. B. Starren
    Columbia University College of Physicians & Surgeons, New York, New York
    Biomedical Informatics,
    Biomedical Informatics Research Center, Marshfield Clinic, Marshfield, Wisconsin
  • M. F. Chiang
    Columbia University College of Physicians & Surgeons, New York, New York
    Ophthalmology,
    Biomedical Informatics,
  • Footnotes
    Commercial Relationships  A. Lajoie, None; S. Koreen, None; L. Wang, None; S.A. Kane, None; T.C. Lee, None; D.J. Weissgold, None; A.M. Berrocal, None; J.T. Flynn, None; J.B. Starren, None; M.F. Chiang, Unpaid member of Scientific Advisory Board for Clarity Medical Systems (Pleasanton, CA), C.
  • Footnotes
    Support  NIH Grant EY13972 (MFC), Research to Prevent Blindness Career Development Award (MFC)
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 1389. doi:
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      A. Lajoie, S. Koreen, L. Wang, S. A. Kane, T. C. Lee, D. J. Weissgold, A. M. Berrocal, J. T. Flynn, J. B. Starren, M. F. Chiang; Retinopathy of Prematurity Management Using Single-Image vs. Multiple-Image Telemedicine Examinations. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1389.

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Abstract

Purpose: : To compare performance of single-image versus multiple-image telemedicine examinations for diagnosis of retinopathy of prematurity (ROP).

Methods: : 248 eyes from 67 consecutive infants underwent wide-angle retinal imaging by a trained neonatal nurse at 31-33 weeks and/or 35-37 weeks post-menstrual age (PMA) at a single academic institution. Data were uploaded to a web-based telemedicine system and interpreted by three masked retinal specialists. Diagnoses were provided based on single-images, and subsequently on multiple-images, from both eyes of each infant. Findings were compared to a reference standard of indirect ophthalmoscopy by a pediatric ophthalmologist. Primary outcome measures were recommended follow-up interval, presence of plus disease, presence of type-2 prethreshold or worse ROP, and presence of visible peripheral ROP.

Results: : Among the three graders, mean sensitivity/specificity for detection of infants requiring follow-up in <1 week were 0.85/0.93 by single-image examination, and 0.91/0.88 by multiple-image examination at 35-37 weeks PMA. Mean sensitivity/specificity for detection of infants with type-2 or worse ROP were 0.82/0.95 by single-image examination, and 1.00/0.87 by multiple-image examination at 35-37 weeks PMA. Mean sensitivity/specificity for detection of plus disease were 1.00/0.86 by single-image examination, and 1.00/0.87 by multiple-image examination at 35-37 weeks PMA. There were no statistically-significant intra-grader differences between single-image and multiple-image telemedicine examinations for detection of plus disease or type-2 or worse ROP.

Conclusions: : Single-image telemedicine exam performs comparably to multiple-image examination for detection of clinically-significant ROP. This may have implications for development of screening protocols, particularly in areas with limited access to ophthalmic care.

Keywords: retinopathy of prematurity • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: health care delivery/economics/manpower 
© 2008, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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