Detection of Clinically Significant Retinopathy of Prematurity Using Wide-angle Digital Retinal Photography OTA

A Report by the American Academy of Ophthalmology Ophthalmic Technology Assesment Committee Pediatric Ophthalmology/Strabismus Panel: Michael F. Chiang, MD¹; Michele Melia, ScM²; Angela N. Buffenn, MD, MPH³; Scott R. Lambert, MD⁴; Franco M. Recchia, MD⁵; Jennifer L. Simpson, MD⁶; Michael B. Yang, MD⁷

Ophthalmology, June 2012, Vol 119, 1272-1280 © 2012 by the American Academy of Ophthalmology. Click here for free access to the OTA.

Reviewed for currency: 2018

Objective: To evaluate the accuracy of detecting clinically significant retinopathy of prematurity (ROP) using wide-angle digital retinal photography.

Methods: Literature searches of PubMed and the Cochrane Library databases were conducted last on December 7, 2010, and yielded 414 unique citations. The authors assessed these 414 citations and marked 82 that potentially met the inclusion criteria. These 82 studies were reviewed in full text; 28 studies met inclusion criteria. The authors extracted from these studies information about study design, interventions, outcomes, and study quality. After data abstraction, 18 were excluded for study deficiencies or because they were superseded by a more recent publication. The methodologist reviewed the remaining 10 studies and assigned ratings of evidence quality; 7 studies were rated level I evidence and 3 studies were rated level III evidence.

Results: There is level I evidence from ≥5 studies demonstrating that digital retinal photography has high accuracy for detection of clinically significant ROP. Level III studies have reported high accuracy, without any detectable complications, from real-world operational programs intended to detect clinically significant ROP through remote site interpretation of wide-angle retinal photographs.

Conclusions: Wide-angle digital retinal photography has the potential to complement standard ROP care. It may provide advantages through objective documentation of clinical examination findings, improved recognition of disease progression by comparing previous photographs, and the creation of image libraries for education and research.

¹Knowles Professor of Ophthalmology & Medical Informatics and Clinical Epidemiology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
²Jaeb Center for Health Research, Tampa, Florida
³The Vision Center, Children's Hospital Los Angeles; Orbit and Eye Movement Institute, Strabismus and Pediatric Ophthalmology; Fellowship Program, Pediatric Ophthalmology and Strabismus; University of Southern California Keck School of Medicine, Los Angeles, California
⁴R. Howard Dobbs Professor of Ophthalmology, Professor of Pediatrics, Department of Ophthalmology, Emory University, Atlanta, Georgia
⁵Tennessee Retina PC, Nashville, Tennessee
⁶Department of Ophthalmology, School of Medicine, University of California, Irvine, California
⁷Abrahamson Pediatric Eye Institute, Cincinnati Children's Hospital Medical Center, Department of Ophthalmology, University of Cincinnati, College of Medicine, Cincinnati, Ohio