title: Risk stratification of preplus retinopathy of prematurity by semiautomated analysis of digital images.
abstract: OBJECTIVE
  To determine whether quantitative analysis of retinal vessel width and tortuosity from digital images discriminates which eyes with preplus retinopathy of prematurity (ROP) progress to treatment severity.
  
  
  METHODS
  Posterior pole images of eyes at first clinical diagnosis of preplus ROP were obtained using a 30 degrees-field, noncontact fundus camera. Width and tortuosity of retinal vessels were analyzed from digital images using computer-assisted image analysis software. Mean width and tortuosity of venules and arterioles were compared in 19 preplus eyes that regressed spontaneously and 11 preplus eyes that progressed to treatment severity. Receiver operating characteristic curve analysis was performed to assess whether width and tortuosity discriminated between groups.
  
  
  RESULTS
  Mean widths of venules alone, arterioles alone, and the 3 widest vessels were higher in preplus progressed eyes (P < .04). Mean tortuosity of the 3 most tortuous vessels was higher in preplus progressed than in preplus regressed eyes (P = .01). Most vessel width and tortuosity variables predicted which eyes with preplus progressed to treatment moderately well, with an area under the receiver operating characteristic curve of 0.72 to 0.82.
  
  
  CONCLUSIONS
  Digital image analysis of retinal vessel width and tortuosity may be useful in predicting which preplus ROP eyes will require treatment. Because vascular abnormalities are a continuum and clinical diagnosis is subjective, quantitative analysis may improve risk stratification for ROP.
authors.affiliation: Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104-4399, USA.
authors.forename: Devon H
authors.initials: DH
authors.lastname: Ghodasra
authors.forename: Karen A
authors.initials: KA
authors.lastname: Karp
authors.forename: Gui-Shuang
authors.initials: GS
authors.lastname: Ying
authors.forename: Monte D
authors.initials: MD
authors.lastname: Mills
authors.forename: Clare
authors.initials: C
authors.lastname: Wilson
authors.forename: Alistair R
authors.initials: AR
authors.lastname: Fielder
authors.forename: Jeffery
authors.initials: J
authors.lastname: Ng
authors.forename: Graham E
authors.initials: GE
authors.lastname: Quinn
mesh_terms: D019540:Area Under Curve; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D012372:ROC Curve; D012161:Retinal Artery / Q000002:abnormalities* / Q000473:pathology; D012169:Retinal Vein / Q000002:abnormalities* / Q000473:pathology; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000628:therapy; D018570:Risk Assessment