ArticleOphthalmology. Retina2022
Variability in Plus Disease Diagnosis using Single and Serial Images.
Article in Ophthalmology. Retina, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Application of a Quantitative Vascular Severity Score in Retinopathy of Prematurity in the United States and India: New Insights Into Disease Epidemiology and Pathophysiology.American journal of ophthalmology · 2026Article
- Impact of image enhancement on grading agreement of plus disease features in retinopathy of prematurity.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Automated Feature Segmentation of Ultra-Widefield OCT Images.Ophthalmology science · 2026Article
- Explainability-informed patient-disjoint evaluation of deep learning for plus disease in retinopathy of prematurity with an ophthalmologist reader study.Frontiers in medicine · 2026Article
- Automatic Diagnosis of Plus Disease in Retinopathy of Prematurity Using Deep Learning.Beyoglu eye journal · 2026Article
- Does field of view matter? Assessing its impact on Plus disease diagnosis in retinopathy of prematurity.International journal of retina and vitreous · 2025Article
- Use of an Artificial Intelligence-Generated Vascular Severity Score Improved Plus Disease Diagnosis in Retinopathy of Prematurity.Ophthalmology · 2024Article
- Focused review on artificial intelligence for disease detection in infants.Frontiers in digital health · 2024Review
- Telemedicine retinopathy of prematurity severity score (TeleROP-SS) versus modified activity score (mROP-ActS) retrospective comparison in SUNDROP cohort.Scientific reports · 2023Article
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Authors and funding
20 authors.
Funding
Abstract
purposeTo assess changes in retinopathy of prematurity (ROP) diagnosis in single and serial retinal images.
designCohort study.
participantsCases of ROP recruited from the Imaging and Informatics in Retinopathy of Prematurity (i-ROP) consortium evaluated by 7 graders.
methodsSeven ophthalmologists reviewed both single and 3 consecutive serial retinal images from 15 cases with ROP, and severity was assigned as plus, preplus, or none. Imaging data were acquired during routine ROP screening from 2011 to 2015, and a reference standard diagnosis was established for each image. 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. This score has been previously demonstrated to correlate with the International Classification of ROP. Mean plus disease severity was calculated by averaging 14 labels per image in serial and single images to decrease noise.
main outcome measuresGrading severity of ROP as defined by plus, preplus, or no ROP.
resultsAssessment of serial retinal images changed the grading severity for > 50% of the graders, although there was wide variability. Cohen's kappa ranged from 0.29 to 1.0, which showed a wide range of agreement from slight to perfect by each grader. Changes in the grading of serial retinal images were noted more commonly in cases of preplus disease. The mean severity in cases with a diagnosis of plus disease and no disease did not change between single and serial images. 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 VSS correlated with mean plus disease severity by expert diagnosis (correlation coefficient, 0.89). The more aggressive graders tended to be influenced by serial images to increase the severity of their grading. The VSS also demonstrated agreement with disease progression across serial images, which progressed to preplus and plus disease.
conclusionsClinicians demonstrated variability in ROP diagnosis when presented with both single and serial images. The use of deep learning as a quantitative assessment of plus disease has the potential to standardize ROP diagnosis and treatment.
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