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
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:https://doi.org/
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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. doi: https://doi.org/.

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

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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 
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