title: Real-time, computer-assisted quantification of plus disease in retinopathy of prematurity at the bedside.
abstract: OBJECTIVE
  Plus disease is the primary indication for retinopathy of prematurity (ROP) treatment, but in borderline cases ophthalmologists may struggle to judge whether it is present. ROPtool is a semi-automated computer program that objectively assesses plus disease by measuring retinal vascular tortuosity and width. This study determined ROPtool's bedside diagnostic accuracy concurrent with ROP screening.
  
  
  METHODS
  ROP screening examinations were recorded using Keeler video indirect ophthalmoscopy. A masked operator traced images in ROPtool at the bedside, comparing ROPtool's plus diagnosis to the examiner's clinical judgment.
  
  
  RESULTS
  Four hundred sixty-four examinations (129 eyes of 65 infants) were performed. ROPtool's sensitivity, specificity, and area under the receiver operating characteristic curve for plus diagnosis was 71% (CI: 38%-100%), 93% (CI: 89%-98%) and 0.87, and for pre-plus or worse was 68% (CI: 51%-85%), 82% (CI: 77%-86%) and 0.81, respectively.
  
  
  CONCLUSIONS
  ROPtool can provide a real-time second opinion of plus disease at the bedside. Image enhancement technologies may further improve ROPtool's diagnostic accuracy.
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Cabrera
authors.forename: Sharon F
authors.initials: SF
authors.lastname: Freedman
authors.forename: Mary Elizabeth
authors.initials: ME
authors.lastname: Hartnett
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Stinnett
authors.forename: Bei Bei
authors.initials: BB
authors.lastname: Chen
authors.forename: David K
authors.initials: DK
authors.lastname: Wallace
mesh_terms: D019540:Area Under Curve; D003199:Computer Systems; D003936:Diagnosis, Computer-Assisted; D005124:Eye Abnormalities / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D009887:Ophthalmoscopy; D019095:Point-of-Care Systems; D012372:ROC Curve; D015203:Reproducibility of Results; D012171:Retinal Vessels / Q000002:abnormalities*; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D012680:Sensitivity and Specificity