Fluorescein angiography images may aid ROP diagnosis

The pairing of fluorescein angiography and color fundus photographs may improve the sensitivity of retinopathy of prematurity diagnosis by pediatric ophthalmologists and retina specialists, according to a study

The prospective cohort study compared nine ROP experts’ interpretations of 16 color fundus photographs vs. 16 color fundus photographs paired with corresponding fluorescein angiography (FA) images to determine diagnoses and management plans.

With the addition of FA images, there was a significant increase in sensitivity for the diagnosis of ROP stage 3 or worse, with an increase from 39.8% with just color photographs to 74.1% with the paired images; pre-plus or worse disease, with an increase from 50.5% to 62.6%; and type 2 ROP or worse, with an increase from 69.4% to 86.8%. The diagnosis of ROP requiring treatment increased from 22.2% to 40.3%, which was not significant.

There was a significant improvement in intergrader agreement among experts for the diagnosis of ROP requiring treatment, with a mean statistic increase from 0.003 with just color photographs to 0.089 with the paired images. The addition of FA images did not significantly affect intergrader agreement regarding the diagnosis of stage, zone or plus disease.

“Overall, this study contributes to the body of ROP knowledge by showing that, compared with color fundus photographs alone, FA may improve the sensitivity of diagnosis by ROP experts, particularly for stage 3 disease, and in turn may improve accuracy of diagnosis of type 2 ROP or worse and ROP requiring treatment,” the study authors said. – by Kristie L. Kahl

Disclosure: Klufas reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Klufas MA, et al. Ophthalmology. 2015;doi:10.1016/j.ophtha.2015.04.023.