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Asymmetry of Retinopathy of Prematurity Border in the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity Study

DOI:10.1016/j.oret.2018.10.003 期刊:Ophthalmology Retina 出版年份:2018 更新时间:2025-09-23 15:21:01
摘要: Purpose: To measure the location of the retinopathy of prematurity (ROP) border in a sample of premature infants who developed ROP and determine location for predicting subsequent development of referral-warranted ROP (RW-ROP, defined as Stage 3 ROP, zone I ROP, or plus disease) or treated ROP. Design: Secondary analysis of data from an observational cohort study, The Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity (e-ROP) study. Subjects: Infants with birth weight (BW) less than 1251g with at least one exam and image session at ≤34 weeks postmenstrual age (PMA) with ROP not meeting RW-ROP, and at least one subsequent exam at ≥36 weeks PMA. Methods: The 5-image set from the first imaging session for each eligible eye was mosaicked, and measurements of the ROP border in each mosaicked image were made using Image J. Measurements were compared among 3 groups of eyes with ROP: (1) never developed RW-ROP or received treatment, (2) developed RW-ROP but did not receive treatment, and (3) received treatment; using analysis of variance and linear trend tests that accounted for the inter-eye correlation. Main outcome measures: RW-ROP, treated ROP Results: 317 eyes from 217 infants with mean BW 755g, mean GA 25 weeks, and mean PMA 33 weeks at first exam met study criteria. Of 211 (66.6%) eyes with sufficient quality images for grading, 147 (69.7%) did not develop RW-ROP or receive treatment, 36 (17.1%) developed RW-ROP not requiring treatment, and 28 (13.3%) received treatment for ROP. Among all eyes, the disc-to-ROP border distance followed a consistent pattern, with nasal < inferior < superior < temporal. Eyes that developed RW-ROP or underwent treatment had significantly shorter nasal and temporal disc-to-ROP border distances and smaller areas of retina within the ROP border. In multivariate analysis adjusted by BW and GA, nasal ROP border distance was a significant predictor of developing treated ROP (OR=0.86 for every 10 pixel increase in distance, p=0.002). Conclusions: ROP is located asymmetrically around the optic disc and is closest to the optic disc nasally. Location of ROP nasally at first imaging is a significant predictor of developing treated ROP.
作者: Tianyu Liu,Gui-shuang Ying,Wei Pan,Eli Smith,Agnieshka Baumritter,Graham E. Quinn
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To measure the location of the retinopathy of prematurity (ROP) border in a sample of premature infants who developed ROP and determine location for predicting subsequent development of referral-warranted ROP (RW-ROP, defined as Stage 3 ROP, zone I ROP, or plus disease) or treated ROP.

ROP is located asymmetrically around the optic disc and is closest to the optic disc nasally. Location of ROP nasally at first imaging is a significant predictor of developing treated ROP.

The mosaicking process may have introduced minor distortions that affected the distance measurements. The images of sufficient quality for grading were from infants with lower mean GA than images of insufficient quality, and so our findings may not be generalizable to all infants undergoing ROP screening. Image analysis procedures for the primary analysis were done by a single grader, which may have introduced bias.

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