title: Efficacy of wide-field digital retinal imaging for retinopathy of prematurity screening.
abstract: BACKGROUND
  To evaluate the efficacy of wide-field digital retinal imaging for retinopathy of prematurity screening.
  
  
  METHODS
  Retrospective study in a quaternary public neonatal intensive care unit.
  
  
  METHODS
  A total of 108 premature infants screened for retinopathy of prematurity.
  
  
  METHODS
  Retrospective chart and photo review were performed on participants screened by both serial wide-field digital retinal imaging and concurrent binocular indirect ophthalmoscopy. Review of captured digital photos was performed independently by a masked reader. Using the binocular indirect ophthalmoscopy findings as the gold standard, the efficacy of wide-field digital retinal imaging in detecting treatment-requiring retinopathy of prematurity, defined as type 1 prethreshold disease, was determined.
  
  
  METHODS
  Sensitivity and specificity of wide-field digital retinal imaging in detecting treatment-requiring retinopathy of prematurity.
  
  
  RESULTS
  Treatment-requiring retinopathy of prematurity was detected in 11 infants by both binocular indirect ophthalmoscopy examination and telemedicine images taken at the same visit. Wide-field digital retinal imaging has a sensitivity of 100% (95% CI: 76.2-100%) and a specificity of 97.9% (95% CI: 93.4-99.7%) in detecting infants with treatment-requiring retinopathy of prematurity. Positive and negative predictive values of wide-field digital retinal imaging were 84.6% (95% CI: 57.8-97.3%) and 100% (95% CI: 96.9-100%), respectively.
  
  
  CONCLUSIONS
  Wide-field digital retinal imaging is accurate, reliable and efficient in detecting treatment-requiring retinopathy of prematurity. Incorporating wide-field digital retinal imaging with telemedicine in standard retinopathy of prematurity management can potentially improve delivery, accessibility, quality and cost of retinopathy of prematurity care.
authors.affiliation: Department of Ophthalmology, Greenlane Clinical Centre, University of Auckland, New Zealand. shuan.dai@gmail.com
authors.forename: Shuan
authors.initials: S
authors.lastname: Dai
authors.forename: Kent
authors.initials: K
authors.lastname: Chow
authors.forename: Andrea
authors.initials: A
authors.lastname: Vincent
mesh_terms: D001724:Birth Weight; D005189:False Positive Reactions; D005260:Female; D005865:Gestational Age; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D009887:Ophthalmoscopy; D010781:Photography; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012160:Retina / Q000473:pathology*; D012178:Retinopathy of Prematurity / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017216:Telemedicine