Predictors of treatment-warranted retinopathy of prematurity in the SUNDROP cohort: influence of photographic features

Ludwig, Cassie A.; Greven, Margaret A.; Moshfeghi, Darius M.

doi:10.1007/s00417-017-3745-3

Cited by 8 publications

(2 citation statements)

References 50 publications

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“…During standard-of-care ophthalmoscopic examinations, a fellowship-trained pediatric ophthalmologist graded fundus pigmentation as blond, medium, or dark using previously published fundus photographs as reference. 31 For infants who had two different fundus pigmentations recorded during the nursery stay ( n = 4), the most frequently recorded fundus pigmentation was used for analysis. Clinicians were masked to OCT findings.…”

Section: Methodsmentioning

confidence: 99%

Ocular Pigmentation Impact on Retinal Versus Choroidal Optical Coherence Tomography Imaging in Preterm Infants

Seely

McCall

Ying

et al. 2023

Trans. Vis. Sci. Tech.

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Purpose To evaluate the association of fundus pigmentation with the visibility of retinal versus choroidal layers on optical coherence tomography (OCT) in preterm infants. Methods For infants enrolled in BabySTEPS, ophthalmologists recorded fundus pigmentation (blond, medium, or dark) at the first retinopathy of prematurity (ROP) examination. Bedside OCT imaging was performed at each examination, and a masked grader evaluated all OCT scans from both eyes of each infant for visibility (yes/no) of all retinal layers and of the chorio–scleral junction (CSJ). Multivariable logistic regression was used to assess associations between fundus pigmentation and visibility of all retinal layers and CSJ, controlling for potential confounders (i.e., birth weight, gestational age, sex, OCT system, pupil size, and postmenstrual age at imaging). Results Among 114 infants (mean birth weight, 943 grams; mean gestational age, 27.6 weeks), 43 infants (38%) had blond, 56 infants (49%) had medium, and 15 infants (13%) had dark fundus pigmentation. Of 1042 scans, all retinal layers were visible in 977 (94%) and CSJ in 895 (86%). Pigmentation was not associated with retinal layer visibility ( P = 0.49), but medium and dark pigmentation were associated with decreased CSJ visibility (medium: odds ratio [OR] = 0.34, P = 0.001; dark: OR = 0.24, P = 0.009). For infants with dark pigmentation, retinal layer visibility increased (OR = 1.87 per week; P ≤ 0.001) and CSJ visibility decreased (OR = 0.78 per week; P = 0.01) with increasing age. Conclusions Although fundus pigmentation was not associated with the visibility of all retinal layers on OCT, darker pigmentation decreased CSJ visibility, and this effect increased with age. Translational Relevance The ability of bedside OCT to capture retinal layer microanatomy in preterm infants, regardless of fundus pigmentation, may represent an advantage over fundus photography for ROP telemedicine.

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Section: Methodsmentioning

confidence: 99%

Ocular Pigmentation Impact on Retinal Versus Choroidal Optical Coherence Tomography Imaging in Preterm Infants

Seely

McCall

Ying

et al. 2023

Trans. Vis. Sci. Tech.

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“…cal Computing, Vienna, Austria). Analysis of grading variable agreement was modeled after prior studies of image-based ROP grading 19,21,27,31,32 . Image scores were analyzed by "individual" week-to-week assessments of ROP progression (scale of − 1 to + 1) and as "longitudinal" total scores across all 5 grading sessions, using the sum of each week-to-week assessment (scale − 5 to + 5) to assess overall disease trajectory.…”

Section: Statistical Analysis All Statistical Analysis Was Conductedmentioning

confidence: 99%

Key factors in a rigorous longitudinal image-based assessment of retinopathy of prematurity

Rosenblatt¹,

Ji²,

Vail³

et al. 2021

Sci Rep

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To describe a database of longitudinally graded telemedicine retinal images to be used as a comparator for future studies assessing grader recall bias and ability to detect typical progression (e.g. International Classification of Retinopathy of Prematurity (ICROP) stages) as well as incremental changes in retinopathy of prematurity (ROP). Cohort comprised of retinal images from 84 eyes of 42 patients who were sequentially screened for ROP over 6 consecutive weeks in a telemedicine program and then followed to vascular maturation or treatment, and then disease stabilization. De-identified retinal images across the 6 weekly exams (2520 total images) were graded by an ROP expert based on whether ROP had improved, worsened, or stayed the same compared to the prior week’s images, corresponding to an overall clinical “gestalt” score. Subsequently, we examined which parameters might have influenced the examiner’s ability to detect longitudinal change; images were graded by the same ROP expert by image view (central, inferior, nasal, superior, temporal) and by retinal components (vascular tortuosity, vascular dilation, stage, hemorrhage, vessel growth), again determining if each particular retinal component or ROP in each image view had improved, worsened, or stayed the same compared to the prior week’s images. Agreement between gestalt scores and view, component, and component by view scores was assessed using percent agreement, absolute agreement, and Cohen’s weighted kappa statistic to determine if any of the hypothesized image features correlated with the ability to predict ROP disease trajectory in patients. The central view showed substantial agreement with gestalt scores (κ = 0.63), with moderate agreement in the remaining views. Of retinal components, vascular tortuosity showed the most overall agreement with gestalt (κ = 0.42–0.61), with only slight to fair agreement for all other components. This is a well-defined ROP database graded by one expert in a real-world setting in a masked fashion that correlated with the actual (remote in time) exams and known outcomes. This provides a foundation for subsequent study of telemedicine’s ability to longitudinally assess ROP disease trajectory, as well as for potential artificial intelligence approaches to retinal image grading, in order to expand patient access to timely, accurate ROP screening.

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Imaging Modalities in Pediatric Vitreoretinal Disorders

Cernichiaro-Espinosa

Tran

Berrocal

2018

Curr Ophthalmol Rep

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Predictors of treatment-warranted retinopathy of prematurity in the SUNDROP cohort: influence of photographic features

Cited by 8 publications

References 50 publications

Ocular Pigmentation Impact on Retinal Versus Choroidal Optical Coherence Tomography Imaging in Preterm Infants

Ocular Pigmentation Impact on Retinal Versus Choroidal Optical Coherence Tomography Imaging in Preterm Infants

Key factors in a rigorous longitudinal image-based assessment of retinopathy of prematurity

Imaging Modalities in Pediatric Vitreoretinal Disorders

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