Image analysis for retinopathy of prematurity diagnosis.

Purpose: To review findings from the authors' published studies involving telemedicine and image analysis for retinopathy of prematurity (ROP) diagnosis.

Methods: Twenty-two ROP experts interpreted a set of 34 wide-angle retinal images for presence of plus disease. For each image, a reference standard diagnosis was defined from expert consensus.

Parental perceptions toward digital imaging and telemedicine for retinopathy of prematurity management.

Background: Telemedicine is an emerging technology with potential to improve care for retinopathy of prematurity (ROP). This study evaluates parental perceptions about digital imaging and telemedicine for ROP care.

Methods: During a 1-year period, one parent of each infant who underwent wide-field retinal imaging for ROP was given a questionnaire designed to evaluate parental perceptions using a 5-point Likert-type scale.

Typical variations of subthalamic electrode location do not predict limb motor function improvement in Parkinson's disease.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for patients with medically refractory Parkinson's disease (PD). The degree to which the anatomic location of the DBS electrode tip determines the improvement of contralateral limb movement function has not been defined. This retrospective study was performed to address this issue.

Retinopathy of prematurity management using single-image vs multiple-image telemedicine examinations.

Purpose: To compare performance of single-image vs multiple-image telemedicine examinations for retinopathy of prematurity (ROP) diagnosis.

Design: Prospective comparative study.

Methods: A total of 248 eyes from 67 consecutive infants underwent wide-angle retinal imaging by a trained neonatal nurse at 31 to 33 weeks and/or 35 to 37 weeks postmenstrual age (PMA) at a single academic institution.

Plus disease in retinopathy of prematurity: an analysis of diagnostic performance.

Purpose: To measure agreement and accuracy of plus disease diagnosis among retinopathy of prematurity (ROP) experts; and to compare expert performance to that of a computer-based analysis system, Retinal Image multiScale Analysis.

Methods: Twenty-two recognized ROP experts independently interpreted a set of 34 wide-angle retinal photographs for presence of plus disease. Diagnostic agreement was analyzed.

Plus disease in retinopathy of prematurity: pilot study of computer-based and expert diagnosis.

Purpose: To measure accuracy of plus disease diagnosis by recognized experts in retinopathy of prematurity (ROP), and to conduct a pilot study examining performance of a computer-based image analysis system, Retinal Image multiScale Analysis (RISA).

Methods: Twenty-two ROP experts independently interpreted a set of 34 wide-angle retinal images for presence of plus disease. A reference standard diagnosis based on expert consensus was defined for each image.

Telemedical retinopathy of prematurity diagnosis: accuracy, reliability, and image quality.

Objective: To prospectively measure accuracy, reliability, and image quality of telemedical retinopathy of prematurity (ROP) diagnosis.

Methods: Two-hundred forty-eight eyes from 67 consecutive infants underwent wide-angle retinal imaging by a trained neonatal nurse at 31 to 33 weeks' and/or 35 to 37 weeks' postmenstrual age (PMA) using a standard protocol. Data were uploaded to a Web-based telemedicine system and interpreted by 3 expert retinal specialist graders who provided a diagnosis (no ROP, mild ROP, type 2 prethreshold ROP, treatment-requiring ROP) and an evaluation of image quality for each eye.

Interexpert agreement of plus disease diagnosis in retinopathy of prematurity.

Objective: To measure agreement of plus disease diagnosis among retinopathy of prematurity (ROP) experts.

Methods: A set of 34 wide-angle retinal photographs from infants with ROP was compiled on a secure Web site and was interpreted independently by 22 recognized ROP experts. Diagnostic agreement was analyzed using 3-level (plus, pre-plus, or neither) and 2-level (plus or not plus) categorizations.

Assessment of image-based technology: impact of referral cutoff on accuracy and reliability of remote retinopathy of prematurity diagnosis.

Telemedicine has potential to improve the delivery, quality, and accessibility of ophthalmic care for infants with Retinopathy of Prematurity (ROP). Using a telemedicine screening strategy, three potential diagnostic cutoffs may be used to define disease that warrants ophthalmologic referral: presence of any ROP, presence of moderate ("type-2 prethreshold") ROP, or presence of severe ROP requiring treatment. This study examines the relationship between accuracy and reliability of diagnosis by three masked ophthalmologist graders at each of these diagnostic cutoffs.

Accuracy and reliability of remote retinopathy of prematurity diagnosis.

Objective: To determine the accuracy and reliability of retinopathy of prematurity (ROP) diagnosis using remote review of digital images by 3 masked ophthalmologist readers.

Methods: An atlas was compiled of 410 retinal photographs from 163 eyes of 64 low-birth-weight infants taken using a wide-angle digital fundus camera. All the images were independently reviewed by 3 readers, and the diagnosis in each eye was classified into 1 of 4 ordinal categories: no ROP, mild ROP, type 2 prethreshold ROP, or ROP requiring treatment.

Subthalamic stimulation for Parkinson disease: determination of electrode location necessary for clinical efficacy.

Object: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) performed using intraoperative microelectrode recording (MER) to adjust electrode placement has become a widely used treatment for patients with advanced Parkinson disease (PD). Few studies have been conducted to examine the location of implanted electrodes relative to the intended target, and even fewer have been undertaken to investigate the degree to which variations in the location of these electrodes impacts their clinical efficacy. This study was performed to examine these issues.