Aggressive posterior retinopathy of prematurity: a pilot study of quantitative analysis of vascular features

Rany Woo, R. V.Paul Chan, Anand Vinekar, Michael F. Chiang

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Methods: Eight ROP experts interpreted 15 retinal images for AP-ROP and plus disease. Inter-expert agreement was calculated by absolute agreement for AP-ROP and plus, and kappa statistic for each expert was compared with others. Retinal vessels were analyzed by a computer-based system to calculate diameter and integrated curvature (IC). Consensus reference standards for images were developed, and quantitative parameters for arterioles and venules were compared among images with AP-ROP vs. not AP-ROP, plus vs. not plus, and AP-ROP vs. plus.

Purpose: To evaluate aggressive posterior retinopathy of prematurity (AP-ROP) with regard to inter-expert diagnostic agreement and quantitative vascular features.

Results: Mean kappa for each expert in AP-ROP diagnosis ranged from −0.15 (no agreement) to 0.42 (moderate agreement). Nine (30 %) of 30 total AP-ROP diagnoses were also classified as not plus disease. Analysis of images with AP-ROP vs. plus showed that images with AP-ROP had higher venular IC (p = 0.04). Arteriolar IC was statistically significant between images with AP-ROP vs. not AP-ROP (p = 0.01) and plus vs. not plus (p = 0.00003). There were no statistically significant differences in diameter between image groups.

Conclusions: Inter-expert agreement with regard to AP-ROP diagnosis is imperfect. Venular curvature may be a distinguishing characteristic between AP-ROP and plus. Future studies involving quantitative features of AP-ROP will have benefits for clinical diagnosis and management.

Original languageEnglish (US)
Pages (from-to)181-187
Number of pages7
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Issue number2
StatePublished - Feb 2014


  • Image analysis
  • Medical informatics
  • Pediatric ophthalmology
  • Retina
  • Retinopathy of prematurity

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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