Department of Ophthalmology, Duke University, Durham, North Carolina.
Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts.
J AAPOS. 2021 Feb;25(1):25.e1-25.e7. doi: 10.1016/j.jaapos.2020.08.015. Epub 2021 Feb 20.
To quantitatively compare retinal vascular characteristics over time in eyes eventually treated versus not treated for retinopathy of prematurity (ROP), using ROPtool analysis of narrow-field retinal images.
This longitudinal study used prospectively collected narrow-field retinal images of infants screened for ROP, prior to treatment, if needed. Images were analyzed using a methodology that combines quadrant-level measures from several images of the same eye. For the longitudinal analysis, one examination per postmenstrual age (PMA) was included per eye. We compared the following ROPtool indices and their change per week between eyes eventually treated versus not treated for ROP: tortuosity index (TI), dilation index (DI), sum of adjusted indices (SAI), and tortuosity-weighted plus (TWP). Analysis was performed on three levels: eye (mean value/eye), quadrant (highest quadrant value/eye), and blood vessel (highest blood vessel value/eye).
Of 832 examinations (99 infants), 745 images (89.5%) had 3-4 quadrants analyzable by ROPtool. On the eye level, ROPtool indices differed between eyes eventually treated versus not treated at PMA of 33-35 and 37 weeks for TI, SAI, and TWP, and at PMA of 33-34 and 37 weeks for DI (P ≤ 0.0014), and change per week differed between eyes eventually treated versus not treated only for SAI at PMA of 32 weeks (P < 0.001).
Quantitative analysis of retinal vascular characteristics using ROPtool can help predict eventual need for treatment for ROP as early as 32 weeks PMA. ROPtool index values were more useful than change in these indices to predict eyes that would eventually need treatment for ROP.
使用 ROPtool 分析窄视野视网膜图像，定量比较早产儿视网膜病变（ROP）最终治疗与未治疗眼的视网膜血管特征随时间的变化。
这项纵向研究使用了前瞻性收集的ROP 筛查婴儿的窄视野视网膜图像，如有需要，在治疗前进行。使用一种将同一眼的几张图像的象限级测量值相结合的方法对图像进行分析。对于纵向分析，每只眼每一个校正胎龄（PMA）包含一次检查。我们比较了以下 ROPtool 指数及其每周变化：扭曲指数（TI）、扩张指数（DI）、调整后指数总和（SAI）和扭曲加权和（TWP）。分析在三个层面上进行：眼（眼平均值）、象限（眼最高象限值）和血管（眼最高血管值）。
在 832 次检查（99 例婴儿）中，有 745 次检查（89.5%）有 3-4 个象限可通过 ROPtool 进行分析。在 PMA 为 33-35 和 37 周时，眼水平的 TI、SAI 和 TWP，以及 PMA 为 33-34 和 37 周时的 DI 指数在最终治疗与未治疗眼之间存在差异（P≤0.0014），仅在 PMA 为 32 周时，SAI 的每周变化在最终治疗与未治疗眼之间存在差异（P<0.001）。
使用 ROPtool 对视网膜血管特征进行定量分析，早在 32 周 PMA 时就可以帮助预测 ROP 最终治疗的需要。ROPtool 指数值比这些指数的变化更有助于预测最终需要治疗 ROP 的眼睛。
