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Screening of at-risk ROP patients: use of a single small field image centred on the optic disc
Yse Borella1, Thibaut Chapron2,3, Florence Metge2
1Pediatric Ophthalmology Department, Fondation Ophtalmologique Adolphe de Rothschild, Paris, Île-de-France, France yse.borella@gmail.com.
Insights
A single optic nerve-centered image can effectively screen for treatment-requiring retinopathy of prematurity (ROP) in premature infants. This method reduces screening burden and infant stress without compromising diagnostic accuracy.
Area of Science:
- Ophthalmology
- Neonatal care
- Medical imaging
Background:
- Current retinopathy of prematurity (ROP) screening necessitates a full retinal examination, posing a significant burden.
- Developing less invasive screening methods for ROP is crucial for premature infants.
Purpose of the Study:
- To evaluate the efficacy of a single optic nerve-centered image in detecting treatment-requiring ROP.
- To determine if this approach can reduce the screening burden while maintaining diagnostic security.
Main Methods:
- Retrospective case series involving premature infants screened for ROP.
- Analysis of optic nerve-centered images by three independent ROP experts.
- Assessment of vascular dilation and tortuosity using a 1-5 scale.
Main Results:
- 100% sensitivity and 88.9% specificity for detecting prethreshold type 1 ROP were achieved with a cut-off of 3 for vascular dilation/tortuosity.
- 278 infants (556 eyes) were analyzed, with 8.8% requiring treatment.
- 1510 optic disc-centered image sets were analyzed.
Conclusions:
- A single posterior pole image can be used for ROP screening.
- This method reduces stress for premature infants compared to traditional dilated fundus examinations.
- Screening quality is maintained without degradation.
Objective:
Currently, retinopathy of prematurity (ROP) screening requires a full retinal examination. To reduce the screening burden, we assessed whether a single optic nerve-centred image could detect treatment-requiring ROP. The objective is to investigate the use of a single image centred around the optic disc to detect treatment-requiring ROP, to reduce the burden of ROP screening with the same security of a full retinal examination.
Design:
Retrospective case series.
Setting:
Tertiary referral centre.
Population:
Premature infants screened for ROP in a tertiary referral centre.
Main Outcome:
Vascular dilation and tortuosity on a scale from 1 to 5 were blindly labelled by three independent ROP experts using a 8 by 8 mm optic nerve-centred images. Images were automatically generated from images of the routine screening examinations.
Results:
A total of 278 patients (556 eyes) with a mean gestational age of 28.4±2.0 weeks and a mean birth weight of 1059.7±324.0 g were included. Treatment was needed in 49 eyes (8.8%) of 25 patients. A total of 1510 image sets centred on the optic disc were obtained and analysed. When the cut-off of the vascular dilatation and tortuosity rating was fixed at 3 (equivalent to a severe preplus disease), sensitivity and specificity for the detection of prethreshold type 1 ROP were 100% and 88.9%, respectively.
Conclusions:
ROP screening using a single posterior pole image could reduce stress in premature infants without degrading the quality of screening, compare to iterative dilated complete fundus examination.
