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Photographic Artifact Resembling International Classification of Retinopathy of Prematurity Stage One and Two

Kyle Hansen1, Sarthak V Shah1, Arthur Brant1

  • 1Byers Eye Institute, Horngren Family Vitreoretinal Center, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California.

Ophthalmic Surgery, Lasers & Imaging Retina
|July 15, 2026
PubMed

Insights

Fundus photography artifacts can mimic early retinopathy of prematurity (ROP) during telemedicine screenings. Recognizing these nonpathologic imaging artifacts is crucial to prevent misdiagnosis and unnecessary interventions in preterm infants.

Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Neonatology

Background:

  • Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
  • Telemedicine facilitates ROP screening, but image interpretation requires careful consideration of potential artifacts.
  • Artifacts in fundus photography can be mistaken for early-stage ROP, potentially leading to overtreatment.

Purpose of the Study:

  • To describe fundus photography artifacts encountered during telemedicine-based ROP screenings.
  • To differentiate these artifacts from actual ROP pathology.
  • To emphasize the importance of artifact awareness in ROP diagnosis.

Main Methods:

  • Retrospective case series of fundus images from ROP screenings.
  • Utilized RetCam Envision camera for image acquisition in telemedicine programs (SUNDROP, TeleROP).
  • Images reviewed by ROP specialists for identification and characterization of artifacts.

Main Results:

  • Identified several fundus photography artifacts resembling stage 1 and 2 ROP.
  • Artifacts exhibited characteristic features such as positional shifts and apparent vessel extension beyond the demarcation line.
  • These features confirmed the nonpathologic nature of the observed artifacts.

Conclusions:

  • Fundus photography artifacts can mimic early ROP, posing a diagnostic challenge in telemedicine screenings.
  • Distinguishing artifacts from true ROP is critical for accurate diagnosis and management.
  • Comparing multiple images and understanding artifact characteristics aid in avoiding misdiagnosis and unnecessary interventions in ROP screening.

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