Department of Ophthalmology, Weill-Cornell Medical College, New York, New York, USA.
Am J Ophthalmol. 2012 Mar;153(3):544-551.e2. doi: 10.1016/j.ajo.2011.08.030. Epub 2011 Oct 22.
To measure accuracy and speed for detection of vascular progression in retinopathy of prematurity (ROP) from serial images. Two strategies are compared: static side-by-side presentation and dynamic flickering of superimposed image pairs.
Prospective comparative study.
Fifteen de-identified, wide-angle retinal image pairs were taken from infants who eventually developed plus disease. Image pairs representing vascular disease progression were taken ≥1 week apart, and control images without progression were taken on the same day. Dynamic flickering pairs were created by digital image registration. Ten experts independently reviewed each image pair on a secure website using both strategies, and were asked to identify progression or state that images were identical. Accuracy and speed were measured, using examination date and ophthalmoscopic findings as a reference standard.
Using static images, experts were accurate in a mean (%) ± standard deviation (SD) of 11.4 of 15 (76%) ± 1.7 image pairs. Using dynamic flickering images, experts were accurate in a mean (%) ± SD of 11.3 of 15 (75%) ± 1.7 image pairs. There was no significant difference in accuracy between these strategies (P = .420). Diagnostic speed was faster using dynamic flickering (24.7 ± 8.3 seconds) vs static side-by-side images (40.3 ± 18.3 seconds) (P = .002). Experts reported higher confidence when interpreting dynamic flickering images (P = .001).
Retinal imaging provides objective documentation of vascular appearance, with potentially improved ability to recognize ROP progression compared to standard ophthalmoscopy. Speed of identifying vascular progression was faster by review of dynamic flickering image pairs than by static side-by-side images, although there was no difference in accuracy.
从连续图像中测量早产儿视网膜病变（ROP）血管进展的检测准确性和速度。比较了两种策略：静态并排呈现和叠加图像对的动态闪烁。
前瞻性比较研究。
从最终发展为加病的婴儿中获取了 15 对已识别的广角视网膜图像。血管疾病进展的图像对相隔至少 1 周拍摄，而无进展的对照图像则在同一天拍摄。动态闪烁对通过数字图像配准创建。十位专家分别使用两种策略在安全网站上独立查看每对图像，并要求他们识别进展或表示图像相同。使用检查日期和检眼镜检查结果作为参考标准，测量准确性和速度。
使用静态图像，专家在 15 对（76%±1.7）图像中的准确率为 11.4（%）±1.7。使用动态闪烁图像，专家在 15 对（75%±1.7）图像中的准确率为 11.3（%）±1.7。这两种策略的准确性没有显着差异（P=0.420）。使用动态闪烁时诊断速度更快（24.7±8.3 秒），而使用静态并排图像时（40.3±18.3 秒）（P=0.002）。专家在解释动态闪烁图像时报告了更高的信心（P=0.001）。
视网膜成像提供了血管外观的客观记录，与标准检眼镜相比，可能具有更好的识别 ROP 进展的能力。与静态并排图像相比，通过查看动态闪烁图像对来识别血管进展的速度更快，但准确性没有差异。
