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Aggressive posterior retinopathy of prematurity: a pilot study of quantitative analysis of vascular features

  • Retinal Disorders
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Abstract

Purpose

To evaluate aggressive posterior retinopathy of prematurity (AP-ROP) with regard to inter-expert diagnostic agreement and quantitative vascular features.

Methods

Eight ROP experts interpreted 15 retinal images for AP-ROP and plus disease. Inter-expert agreement was calculated by absolute agreement for AP-ROP and plus, and kappa statistic for each expert was compared with others. Retinal vessels were analyzed by a computer-based system to calculate diameter and integrated curvature (IC). Consensus reference standards for images were developed, and quantitative parameters for arterioles and venules were compared among images with AP-ROP vs. not AP-ROP, plus vs. not plus, and AP-ROP vs. plus.

Results

Mean kappa for each expert in AP-ROP diagnosis ranged from −0.15 (no agreement) to 0.42 (moderate agreement). Nine (30 %) of 30 total AP-ROP diagnoses were also classified as not plus disease. Analysis of images with AP-ROP vs. plus showed that images with AP-ROP had higher venular IC (p = 0.04). Arteriolar IC was statistically significant between images with AP-ROP vs. not AP-ROP (p = 0.01) and plus vs. not plus (p = 0.00003). There were no statistically significant differences in diameter between image groups.

Conclusions

Inter-expert agreement with regard to AP-ROP diagnosis is imperfect. Venular curvature may be a distinguishing characteristic between AP-ROP and plus. Future studies involving quantitative features of AP-ROP will have benefits for clinical diagnosis and management.

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Acknowledgments

Supported by grant EY19474 from the National Institutes of Health (Bethesda, MD) (MFC), the Friends of Doernbecher foundation (Portland, OR) (MFC), unrestricted departmental funding from Research to Prevent Blindness (New York, NY) (RVPC, MFC), the St. Giles Foundation (New York, NY) (RVPC), and the Yale One Year Medical Fellowship (New Haven, CT) (RW).

Conflicts of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

MFC is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems (Pleasanton, CA, USA).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA

    Rany Woo

  2. Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA

    R. V. Paul Chan

  3. Department of Pediatric Retina, Narayana Nethralaya Postgraduate Institute of Ophthalmology, Rajajinagar, Bangalore, India

    Anand Vinekar

  4. Departments of Ophthalmology and Medical Informatics & Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA

    Michael F. Chiang

  5. Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Boulevard, Portland, OR, 97239, USA

    Michael F. Chiang

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  1. Rany Woo
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  2. R. V. Paul Chan
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  3. Anand Vinekar
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  4. Michael F. Chiang
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Corresponding author

Correspondence to Michael F. Chiang.

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Woo, R., Chan, R.V.P., Vinekar, A. et al. Aggressive posterior retinopathy of prematurity: a pilot study of quantitative analysis of vascular features. Graefes Arch Clin Exp Ophthalmol 253, 181–187 (2015). https://doi.org/10.1007/s00417-014-2857-2

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  • DOI: https://doi.org/10.1007/s00417-014-2857-2

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