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Ana Gonzalez-H.Leon, Guillermo Salcedo-Villanueva, Raul Velez-Montoya, Hugo Quiroz-Mercado, Karen Jazmin Herrera-Juarez, Virgilio Morales-Canton, Jose Francisco Francisco Perez-Vazquez, Juan Carlos Romo-Aguas, Maria Martinez-Castellanos; Inter-rater agreement of posterior segment images in premature babies using the ultra-widefield camera OPTOS®. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2770.
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Advanced retinopathy of prematurity (ROP) must be treated immediately. Since there aren’t enough specialists available to timely assess all at-risk-infants, using the technology available is important. We investigate the level of agreement between two ROP experts when assessing photographs from premature born infants taken with an ultra-widefield camera (Optos®).
Retrospective study where two ROP masked experts (MMC and GSV) independently evaluated a picture of each eye from the clinical record of all the patients that attended consultation for ROP screening between April and June 2017. They placed each image on zone I, II, III, cannot determine, and complete; for evaluating stage they placed each image a value of 1, 2, 3, 4/5, complete and “non-gradable”. No demographic information was provided so their assessment would be based solely on the photographs. Inter-rater agreement was measured using Cohen’s kappa coefficient, results between 0 and 0.20 were considered mild agreement, from 0.21 to 0.4 fair, between 0.41 and 0.60 moderate, between 0.61 and 0.80 substantial, and more than 0.81 almost perfect.
99 photos were examined (50 from right and 49 from left eyes). All infants were born between 25 and 35 weeks of gestation (mean 30.6 weeks), 27 were male (54%). At the time of the exam, patients had an average of 76.7 days (32-244) of extrauterine life. The average birth weight was 1367g (870-2200g). When evaluating zones and stages both inter-rater agreement were substantial (κ = 0.65 and 0.659 respectively), the stage evaluation was substantial as well (κ = 0.659). Representative photographs of each ROP stage in which both examiners agreed were found.
The inter-rater agreement was substantial reinforcing the potential applicability of the camera for obtaining photographs to document assess ROP. The camera permitted the acquisition of gradable images that let us evaluate the posterior segment of preterm infants.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Pseudo-color photography taken with the ultra-wide field Optos Daytona. Right eye from a premature infant. Zone I is encircled. Arrowheads show remnants of the initial ridge. Arrows indicate second ridge.
Left eye from a 9.1-week-old female born at 26 weeks, with 860 g of birth weight. ROP in zone II, stage 3 with plus. Areas of fibrovascular proliferation are seen in the temporal area (white arrows)
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