Real-time, computer-assisted quantification of plus disease in retinopathy of prematurity at the bedside.

BACKGROUND AND

OBJECTIVE

Plus disease is the primary indication for retinopathy of prematurity (ROP) treatment, but in borderline cases ophthalmologists may struggle to judge whether it is present. ROPtool is a semi-automated computer program that objectively assesses plus disease by measuring retinal vascular tortuosity and width. This study determined ROPtool's bedside diagnostic accuracy concurrent with ROP screening.

PATIENTS AND

METHODS

ROP screening examinations were recorded using Keeler video indirect ophthalmoscopy. A masked operator traced images in ROPtool at the bedside, comparing ROPtool's plus diagnosis to the examiner's clinical judgment.

RESULTS

Four hundred sixty-four examinations (129 eyes of 65 infants) were performed. ROPtool's sensitivity, specificity, and area under the receiver operating characteristic curve for plus diagnosis was 71% (CI: 38%-100%), 93% (CI: 89%-98%) and 0.87, and for pre-plus or worse was 68% (CI: 51%-85%), 82% (CI: 77%-86%) and 0.81, respectively.

CONCLUSION

ROPtool can provide a real-time second opinion of plus disease at the bedside. Image enhancement technologies may further improve ROPtool's diagnostic accuracy.