Plus disease in retinopathy of prematurity: Diagnostic impact of field of view

Rohini Rao, Nina J. Jonsson, Camila Ventura, Rony Gelman, Martin A. Lindquist, Daniel S. Casper, Michael Chiang

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

PURPOSE: To examine the impact of retinal field of view and magnification on interexpert reliability of plus disease diagnosis in retinopathy of prematurity. METHODS: Fifteen wide-angle images from infants with retinopathy of prematurity were cropped and adjusted in magnification to create 2 additional image categories: medium angle (40°-50°) and narrow angle (20°-30°). These 45 images were uploaded to a Web-based system and interpreted independently by 13 experts of retinopathy of prematurity using a 3-level (plus, preplus, neither) and 2-level (plus, not plus) classification. Absolute agreement and kappa statistics were calculated to compare interexpert reliability. RESULTS: In the 3-level classification, ≥70% experts agreed on the same diagnosis in 8 of the 15 wide-angle images (53%), but only in 3 of the 15 medium-angle (20%) and 3 of the 15 narrow-angle (20%) images. In the 2-level classification, ≥80% experts agreed on the same diagnosis in 11 of the 15 wide-angle images (73%), but only in 9 of the 15 medium-angle (60%) and 3 of the 15 narrow-angle (20%) images. Mean kappa of each expert compared with all other experts was 0.40 to 0.59 in 8 of 13 experts (62%) using wide-angle images, was 0 to 0.19 in 7 of 13 experts (54%) using medium-angle images, and was 0.20 to 0.39 in 9 of 13 experts (69%) using narrow-angle images. CONCLUSION: Interexpert agreement in plus disease diagnosis in wide-angle images is higher than from medium-angle and narrow-angle images. Plus disease is defined using a narrow-angle standard published photograph, yet this study suggests that peripheral findings also contribute to diagnosis.

Original languageEnglish (US)
Pages (from-to)1148-1155
Number of pages8
JournalRetina
Volume32
Issue number6
DOIs
StatePublished - Jun 2012

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Retinopathy of Prematurity

Keywords

  • medical informatics
  • pediatric ophthalmology
  • retina
  • retinopathy of prematurity
  • telemedicine

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Rao, R., Jonsson, N. J., Ventura, C., Gelman, R., Lindquist, M. A., Casper, D. S., & Chiang, M. (2012). Plus disease in retinopathy of prematurity: Diagnostic impact of field of view. Retina, 32(6), 1148-1155. https://doi.org/10.1097/IAE.0b013e31823ac3c3

Plus disease in retinopathy of prematurity : Diagnostic impact of field of view. / Rao, Rohini; Jonsson, Nina J.; Ventura, Camila; Gelman, Rony; Lindquist, Martin A.; Casper, Daniel S.; Chiang, Michael.

In: Retina, Vol. 32, No. 6, 06.2012, p. 1148-1155.

Research output: Contribution to journalArticle

Rao, R, Jonsson, NJ, Ventura, C, Gelman, R, Lindquist, MA, Casper, DS & Chiang, M 2012, 'Plus disease in retinopathy of prematurity: Diagnostic impact of field of view', Retina, vol. 32, no. 6, pp. 1148-1155. https://doi.org/10.1097/IAE.0b013e31823ac3c3
Rao R, Jonsson NJ, Ventura C, Gelman R, Lindquist MA, Casper DS et al. Plus disease in retinopathy of prematurity: Diagnostic impact of field of view. Retina. 2012 Jun;32(6):1148-1155. https://doi.org/10.1097/IAE.0b013e31823ac3c3
Rao, Rohini ; Jonsson, Nina J. ; Ventura, Camila ; Gelman, Rony ; Lindquist, Martin A. ; Casper, Daniel S. ; Chiang, Michael. / Plus disease in retinopathy of prematurity : Diagnostic impact of field of view. In: Retina. 2012 ; Vol. 32, No. 6. pp. 1148-1155.
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abstract = "PURPOSE: To examine the impact of retinal field of view and magnification on interexpert reliability of plus disease diagnosis in retinopathy of prematurity. METHODS: Fifteen wide-angle images from infants with retinopathy of prematurity were cropped and adjusted in magnification to create 2 additional image categories: medium angle (40°-50°) and narrow angle (20°-30°). These 45 images were uploaded to a Web-based system and interpreted independently by 13 experts of retinopathy of prematurity using a 3-level (plus, preplus, neither) and 2-level (plus, not plus) classification. Absolute agreement and kappa statistics were calculated to compare interexpert reliability. RESULTS: In the 3-level classification, ≥70{\%} experts agreed on the same diagnosis in 8 of the 15 wide-angle images (53{\%}), but only in 3 of the 15 medium-angle (20{\%}) and 3 of the 15 narrow-angle (20{\%}) images. In the 2-level classification, ≥80{\%} experts agreed on the same diagnosis in 11 of the 15 wide-angle images (73{\%}), but only in 9 of the 15 medium-angle (60{\%}) and 3 of the 15 narrow-angle (20{\%}) images. Mean kappa of each expert compared with all other experts was 0.40 to 0.59 in 8 of 13 experts (62{\%}) using wide-angle images, was 0 to 0.19 in 7 of 13 experts (54{\%}) using medium-angle images, and was 0.20 to 0.39 in 9 of 13 experts (69{\%}) using narrow-angle images. CONCLUSION: Interexpert agreement in plus disease diagnosis in wide-angle images is higher than from medium-angle and narrow-angle images. Plus disease is defined using a narrow-angle standard published photograph, yet this study suggests that peripheral findings also contribute to diagnosis.",
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