title: Retinal imaging in premature infants using the Pictor noncontact digital camera.
abstract: OBJECTIVE
  To evaluate, first, the feasibility of using Pictor, a new portable, noncontact digital fundus camera, to obtain high-quality retinal images of prematurely born infants and, second, the accuracy of grading these images for clinically significant posterior pole vascular changes, that is, pre-plus or plus disease, compared to indirect ophthalmoscopy.
  
  
  METHODS
  Pictor retinal images were obtained on a convenience sample of prematurely born infants during routine examinations for retinopathy of prematurity (ROP). Images were reviewed and graded by two ROP experts, who were masked to demographic and clinical examination findings.
  
  
  RESULTS
  A total of 96 eyes of 48 infants were included. The mean field of view was 5.0 × 6.1 disk diameters (DD). Grader 1 found quality to be fair or good in 96% of images; grader 2 in 97% of images. Grader 1 judged images as having at least 1 DD length of a major vessel in 3 or 4 quadrants in 80% of images; grader 2 in 86% of images. The sensitivity and specificity of grading pre-plus or plus disease on Pictor images was 100% and 79%, respectively, for grader 1, and 83% and 85%, respectively, for grader 2, compared to the reference standard of indirect ophthalmoscopy.
  
  
  CONCLUSIONS
  The Pictor fundus camera can capture digital retinal images of prematurely born infants that have quality sufficient for accurate expert grading in comparison to clinical examination. Pictor shows promise as an ROP screening tool.
authors.affiliation: Duke Eye Center, Durham, North Carolina. Electronic address: grace.prakalapakorn@duke.edu.
authors.forename: Sasapin G
authors.initials: SG
authors.lastname: Prakalapakorn
authors.affiliation: Duke Eye Center, Durham, North Carolina.
authors.forename: David K
authors.initials: DK
authors.lastname: Wallace
authors.affiliation: Duke Eye Center, Durham, North Carolina.
authors.forename: Sharon F
authors.initials: SF
authors.lastname: Freedman
mesh_terms: D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D009887:Ophthalmoscopy; D010781:Photography / Q000295:instrumentation*; D012171:Retinal Vessels / Q000473:pathology*; D012178:Retinopathy of Prematurity / Q000145:classification / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation