Computer program may offer second opinion at bedside for plus disease

A computer program shows promise at being able to provide a second opinion of plus disease at the bedside, according to a study.

ROPtool was used during routine retinopathy of prematurity examinations of 65 premature infants, for a total of 464 examinations in 129 eyes. Keeler digital indirect ophthalmoscopy was used to record examinations, and a diagnosis of plus disease made by ROPtool was compared with the examiner’s clinical judgment.

Plus disease was present in 16 of 462 complete clinical fundus examinations (six out of 65 infants), and pre-plus disease was present in 38 of 462 examinations (14 of 65 infants).

Among the images with both ROPtool traceability and a clinical diagnosis, 15 of 378 were diagnosed with plus disease, and 36 of 378 were diagnosed with pre-plus disease.

For plus disease, the sensitivity, specificity and area under the receiver operating characteristic curve of the ROPtool were 71%, 93% and 0.87, respectively. For pre-plus or worse, sensitivity, specificity and area under the receiver operating characteristic curve were 68%, 82% and 0.81, respectively.

“This study demonstrates that ROPtool’s utility as a clinical adjunct for ROP diagnosis with current video indirect imaging shows promise, but it cannot be considered a highly accurate second opinion at the bedside yet. Image enhancement technologies, advancements in video indirect image quality, use of RetCam [Clarity Medical Systems] instead of video indirect ophthalmoscopy, and adjustments in ROPtool’s pre-plus and plus thresholds may improve ROPtool’s future performance at the bedside,” the study authors said.

Disclosure: The authors have no relevant financial disclosures.