Development of a scale for grading pre-plus and plus disease using retinal images: A pilot study

Area of Science:

• Ophthalmology
• Medical Imaging
• Neonatology

Background:

• Screening infants for retinopathy of prematurity (ROP) involves evaluating posterior pole vascular characteristics, which is subjective and error-prone.
• Pre-plus and plus disease are critical indicators in ROP, but their assessment relies on subjective interpretation of retinal vessel tortuosity and dilation.

Purpose of the Study:

• To develop and validate an abbreviated pictorial scale for assessing vascular changes in retinopathy of prematurity.
• To reduce subjectivity and improve the accuracy of diagnosing pre-plus or plus disease in infants.

Main Methods:

• Created a pictorial scale of varying retinal vascular tortuosity and dilation based on expert opinion.
• Utilized ROPtool, a semiautomated program measuring retinal vessel tortuosity and dilation, to evaluate the scale's effectiveness.
• Assessed experts' ability to order images according to increasing vascular tortuosity and dilation using ROPtool measurements.

Main Results:

• ROPtool measurements confirmed that the experts successfully arranged the pictorial scale images in order of increasing vascular tortuosity and dilation.
• The validated scale demonstrated a quantifiable correlation with objective measurements of vascular characteristics.

Conclusions:

• The developed pictorial scale, validated by ROPtool, can serve as a valuable reference tool.
• This scale has the potential to decrease subjectivity in diagnosing pre-plus or plus disease in retinopathy of prematurity, improving diagnostic consistency.