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Evaluation of vascular disease progression in retinopathy of prematurity using static and dynamic retinal images
Jane S Myung1, Rony Gelman, Grant D Aaker
1Department of Ophthalmology, Weill-Cornell Medical College, New York, New York, USA.
Insights
Dynamic flickering of retinal images improves the speed of detecting retinopathy of prematurity (ROP) vascular progression without affecting accuracy. This method offers a faster interpretation for ROP diagnosis.
Area of Science:
- Ophthalmology
- Medical Imaging
- Neonatology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Early detection of ROP vascular progression is crucial for timely intervention.
- Standard ophthalmoscopy can be subjective; objective documentation methods are needed.
Purpose of the Study:
- To compare the accuracy and speed of detecting ROP vascular progression using two image presentation strategies.
- To evaluate static side-by-side image comparison versus dynamic flickering of superimposed image pairs.
Main Methods:
- A prospective comparative study involving 15 wide-angle retinal image pairs from infants with ROP.
- Image pairs represented vascular progression or controls, reviewed by 10 experts.
- Accuracy and speed were measured for static and dynamic flickering presentations.
Main Results:
- No significant difference in accuracy was found between static (76%) and dynamic flickering (75%) image presentations (P = .420).
- Diagnostic speed was significantly faster with dynamic flickering (24.7s) compared to static images (40.3s) (P = .002).
- Experts reported higher confidence interpreting dynamic flickering images (P = .001).
Conclusions:
- Dynamic flickering of retinal images enhances the speed of ROP vascular progression detection.
- This method provides objective documentation and may improve ROP diagnosis compared to standard ophthalmoscopy.
- While accuracy remains similar, the increased speed and confidence suggest clinical utility.
Purpose:
To measure accuracy and speed for detection of vascular progression in retinopathy of prematurity (ROP) from serial images. Two strategies are compared: static side-by-side presentation and dynamic flickering of superimposed image pairs.
Design:
Prospective comparative study.
Methods:
Fifteen de-identified, wide-angle retinal image pairs were taken from infants who eventually developed plus disease. Image pairs representing vascular disease progression were taken ≥1 week apart, and control images without progression were taken on the same day. Dynamic flickering pairs were created by digital image registration. Ten experts independently reviewed each image pair on a secure website using both strategies, and were asked to identify progression or state that images were identical. Accuracy and speed were measured, using examination date and ophthalmoscopic findings as a reference standard.
Results:
Using static images, experts were accurate in a mean (%) ± standard deviation (SD) of 11.4 of 15 (76%) ± 1.7 image pairs. Using dynamic flickering images, experts were accurate in a mean (%) ± SD of 11.3 of 15 (75%) ± 1.7 image pairs. There was no significant difference in accuracy between these strategies (P = .420). Diagnostic speed was faster using dynamic flickering (24.7 ± 8.3 seconds) vs static side-by-side images (40.3 ± 18.3 seconds) (P = .002). Experts reported higher confidence when interpreting dynamic flickering images (P = .001).
Conclusions:
Retinal imaging provides objective documentation of vascular appearance, with potentially improved ability to recognize ROP progression compared to standard ophthalmoscopy. Speed of identifying vascular progression was faster by review of dynamic flickering image pairs than by static side-by-side images, although there was no difference in accuracy.
