Related Experiment Video
Updated: Aug 8, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
RetCam imaging for retinopathy of prematurity screening
Carolyn Wu1, Robert A Petersen, Deborah K VanderVeen
1Department of Ophthalmology, Children's Hospital Boston, Harvard Medical School, Boston, MA 02116, USA. carolyn.wu@childrens.harvard.edu
Insights
Digital imaging for retinopathy of prematurity (ROP) screening is effective, accurately detecting high-risk disease. While some cases require indirect ophthalmoscopy due to image quality, this method shows promise for reducing overall examinations.
Area of Science:
- Ophthalmology
- Neonatal Care
- Medical Imaging
Background:
- Indirect ophthalmoscopy is the standard for retinopathy of prematurity (ROP) screening.
- Digital imaging offers a potential alternative for ROP screening.
Purpose of the Study:
- To evaluate the clinical outcomes of using digital imaging for high-risk ROP detection.
- To compare digital imaging screening with indirect ophthalmoscopy.
Main Methods:
- Serial RetCam imaging and indirect ophthalmoscopy were performed on 43 premature infants.
- A masked reader assessed images and made management recommendations.
- Screening success was defined by accurate identification of prethreshold or threshold ROP.
Main Results:
- Digital photography demonstrated 100% sensitivity and 97.5% specificity for detecting prethreshold/threshold ROP.
- No cases of significant ROP were missed; 5% were overestimated.
- 21% of screenings were unevaluable due to poor image quality.
Conclusions:
- RetCam imaging effectively detects high-risk ROP when image quality is adequate.
- Ophthalmologic exams were still needed in 20% of cases for reasons like poor image quality.
- Digital imaging may safely decrease the need for indirect ophthalmoscopy.
Purpose:
Indirect ophthalmoscopy is the gold standard for retinopathy of prematurity (ROP) screening. Screening for ROP with digital imaging has been proposed as a possible alternative. Our goal was to evaluate the longitudinal clinical outcomes of employing digital imaging to detect high-risk ROP.
Methods:
Serial RetCam imaging and indirect ophthalmoscopy were performed on 43 premature infants. A masked reader evaluated the images and made management recommendations that were compared with indirect ophthalmoscopy results. Successful screening was determined by correctly identifying progression to prethreshold or threshold disease with referral for indirect ophthalmoscopy. Unsuccessful screening was determined by failure to identify prethreshold or threshold disease, inaccurately detecting prethreshold or threshold disease, or inability to evaluate for ROP.
Results:
No cases of prethreshold or threshold disease were missed by the reader. The reader overestimated prethreshold or threshold disease in 5% of cases. Initial screening in 21% of cases could not be evaluated for ROP secondary to poor image quality. Digital photography had a sensitivity of 100% and specificity of 97.5% in detecting prethreshold and threshold ROP. Positive-predictive value of digital photography was 67% and negative-predictive value was 100%.
Conclusions:
Screening and management of ROP using RetCam imaging did not fail to detect prethreshold or threshold disease when images could be obtained. Ophthalmologic examinations were needed in 20% of cases that did not reach threshold or prethreshold disease because of poor image quality or overestimation of ROP. RetCam screening may safely reduce the overall number of indirect ophthalmologic examinations required.
