Related Experiment Video
Updated: Aug 14, 2026
Monitoring Dynamic Growth of Retinal Vessels in Oxygen-Induced Retinopathy Mouse Model
Published on: April 2, 2021
Diagnosis of plus disease in retinopathy of prematurity using Retinal Image multiScale Analysis
Rony Gelman1, M Elena Martinez-Perez, Deborah K Vanderveen
1Department of Ophthalmology, Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA.
Insights
The Retinal Image multiScale Analysis (RISA) software shows promise for diagnosing plus disease in premature infants with retinopathy of prematurity (ROP). Its analysis of retinal vessel curvature, diameter, and tortuosity accurately identifies this serious condition.
Area of Science:
- Ophthalmology
- Medical Imaging
- Neonatology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of vision impairment in preterm infants.
- Accurate diagnosis of plus disease, a marker of severe ROP, is critical for timely treatment.
- Current diagnostic methods rely on subjective ophthalmic examination.
Purpose of the Study:
- To evaluate the semiautomated Retinal Image multiScale Analysis (RISA) software for diagnosing plus disease in preterm infants with ROP.
- To assess the diagnostic accuracy of RISA parameters (curvature, diameter, tortuosity) in identifying plus disease.
Main Methods:
- Digital retinal images from preterm infants with ROP were analyzed using an enhanced RISA software.
- Vessel parameters (integrated curvature, diameter, tortuosity) were calculated for arterioles and venules.
- Receiver operating characteristic (ROC) curves and areas under the curve (AUC) were used to determine diagnostic accuracy.
Main Results:
- All RISA parameters (curvature, diameter, tortuosity) were significantly larger in infants with plus disease compared to those without.
- RISA demonstrated good accuracy in diagnosing plus disease, with curvature showing the highest diagnostic accuracy (AUC 0.911 for arterioles, 0.824 for venules).
- Median arteriolar and venular diameters were approximately 12 µm greater in the plus disease group.
Conclusions:
- The RISA software and its parameters show strong performance in identifying plus disease in preterm infants with ROP.
- RISA may serve as a valuable, objective tool to aid in the diagnosis of plus disease.
- Further validation of RISA could lead to improved management of ROP.
Purpose:
To evaluate a semiautomated image analysis software package, Retinal Image multiScale Analysis (RISA), for the diagnosis of plus disease in preterm infants with retinopathy of prematurity (ROP).
Methods:
Digital images of the posterior pole showing both disc and macula in preterm infants with ROP were analyzed with an enhanced version of RISA. Venules (N = 106) and arterioles (N = 44) were identified, and integrated curvature, diameter, and tortuosity of the vessels were calculated. After the RISA calculations were completed, the origins of the vessels were determined to be 32 eyes in 16 infants (12 eyes with plus disease, 20 with no plus disease, as diagnosed by ophthalmic examination). Vessels were sorted into two groups-plus disease and no plus disease-and each RISA parameter was compared using the Mann-Whitney test. For each parameter, sensitivity and specificity were plotted as a function of cutoff criterion, receiver operating characteristic (ROC) curves were constructed, and the areas under the curve (AUC) were calculated.
Results:
For both arterioles and venules, each of the three parameters was significantly larger for the plus disease group. For instance, the median estimated arteriolar and venular diameters were approximately 12 mum greater in plus disease. Sensitivity and specificity plots indicated good accuracy of each parameter for the diagnosis of plus disease. The AUC showed that curvature had the highest diagnostic accuracy (0.911 for arterioles, 0.824 for venules).
Conclusions:
The strong performance of RISA parameters in this sample suggests that RISA may be useful for diagnosing plus disease in preterm infants with ROP.
