The use of deep learning as a quantitative assessment of plus disease has the potential to standardize ROP diagnosis and treatment. ![]() The VSS also demonstrated agreement with disease progression across serial images, which progressed to preplus and plus disease.Ĭlinicians demonstrated variability in ROP diagnosis when presented with both single and serial images. The more aggressive graders tended to be influenced by serial images to increase the severity of their grading. The VSS correlated with mean plus disease severity by expert diagnosis (correlation coefficient, 0.89). The ROP VSS demonstrated good correlation with the range of expert classifications of plus disease and overall agreement with the mode class (P = 0.001). The mean severity in cases with a diagnosis of plus disease and no disease did not change between single and serial images. Changes in the grading of serial retinal images were noted more commonly in cases of preplus disease. Cohen's kappa ranged from 0.29 to 1.0, which showed a wide range of agreement from slight to perfect by each grader. Grading severity of ROP as defined by plus, preplus, or no ROP.Īssessment of serial retinal images changed the grading severity for > 50% of the graders, although there was wide variability. Mean plus disease severity was calculated by averaging 14 labels per image in serial and single images to decrease noise. This score has been previously demonstrated to correlate with the International Classification of ROP. A secondary analysis was performed using the i-ROP deep learning system to assign a vascular severity score (VSS) to each image, ranging from 1 to 9, with 9 being the most severe disease. Imaging data were acquired during routine ROP screening from 2011 to 2015, and a reference standard diagnosis was established for each image. ![]() Seven ophthalmologists reviewed both single and 3 consecutive serial retinal images from 15 cases with ROP, and severity was assigned as plus, preplus, or none. Electronic address: assess changes in retinopathy of prematurity (ROP) diagnosis in single and serial retinal images.Ĭases of ROP recruited from the Imaging and Informatics in Retinopathy of Prematurity (i-ROP) consortium evaluated by 7 graders. 13 Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois.12 National Eye Institute, National Institutes of Health, Bethesda, Maryland.11 Harvard Medical School, Boston, Massachusetts.10 Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California.9 Department of Ophthalmology, Columbia University, New York, New York.8 Stein Eye Institute, University of California Los Angeles, Los Angeles, California.7 Department of Ophthalmology, Beaumont Eye Institute, Royal Oak, Michigan. ![]() 6 Bascom Palmer Eye Institute, University of Miami, Miami, Florida.5 Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.4 Wills Eye Hospital, Philadelphia, Pennsylvania.3 Department of Ophthalmology, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 2 Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois Department of Ophthalmology, Seoul St.1 Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois.
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