Agreement among pediatric ophthalmologists in diagnosing plus and pre-plus disease in retinopathy of prematurity
Agreement among pediatric ophthalmologists in diagnosing plus and pre-plus disease in retinopathy of prematurity
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DOI：
10.1016/j.jaapos.2007.11.022
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发表时间：
2008-08-01
期刊：
影响因子：
1.6
通讯作者：
Chiang, Michael F.
中科院分区：
文献类型：
--
作者：
Wallace, David K.;Quinn, Graham E.;Chiang, Michael F.
目的：Plus疾病已成为早产儿视网膜病变（ROP）激光治疗的主要标准，但其评估是主观的。我们的目的是比较象限水平和eve-level的评估，加上疾病和前加疾病3经验丰富的ROP examiners和报告他们的率agreement.METHODS一百八十一个高质量的RetCam图像从早产儿进行了分级的3名作者。扩张和迂曲度分别判断使用正常或足够异常的规模，以满足标准的前加或加disease.Results有分歧油的存在下，加疾病的18个图像（10%），油迂曲度足够的加疾病（加迂曲度）的26个图像（14%），和油扩张足够的加疾病（加扩张）的26个图像（14%）。在67张被判定为前病变或更严重的图像中，18张图像（27%）不同意存在前病变，25张图像（37%）不同意存在前病变，21张图像（31%）不同意存在前病变。为了区分正或正前疾病与正常，有分歧的石油前加迂曲的181图像中的38（21%）和前加扩张的181 images中的58（32%.CONCLUSIONS三个经验丰富的ROP exarniners不同意经常石油诊断正或正前疾病时，评价裁剪的临床照片的婴儿，其中许多有边界正疾病。需要进一步的研究来确定这些观察结果对临床决策的影响。
PURPOSE Plus disease has become the major criterion for laser treatment in Infants with retinopathy of prematurity (ROP), but its assessment is subjective. Our purpose was to compare quadrant-level and eve-level assessment of plus disease and pre-plus disease among 3 experienced ROP examiners and to report their rate of agreement.METHODS One hundred eighty-one high-quality RetCam images from premature infants were graded by 3 of the authors. Dilation and tortuosity were judged separately using a scale of normal or sufficiently abnormal to meet criteria for pre-plus Or Plus disease.RESULTS There was disagreement oil the presence of plus disease for 18 images (10%), oil tortuosity sufficient for Plus disease (Plus tortuosity) for 26 images (14%), and oil dilation sufficient for plus disease (Plus dilation) for 26 images (14%). Of 67 images Judged to have pre-plus disease or worse, there was disagreement oil the presence Of Plus disease for 18 images (27%), oil plus tortuosity for 25 images (37%), and oil plus dilation for 21 images (3 1 %). For distinguishing plus or pre-plus disease from normal, there was disagreement oil pre-plus tortuosity for 38 of 181 images (21%) and on pre-plus dilation for 58 of 181 images (32%).CONCLUSIONS Three experienced ROP exarniners disagreed frequently oil the dijgnosis of plus or pre-plus disease when evaluating cropped clinical photographs of infants, many of which had borderline plus disease. Further study is required to determine the implications of these observations oil clinical decision making.