Training retinal imagers for retinopathy of prematurity (ROP) screening

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• 作者：Karen A. Karp ; BSN ; RN^b ; ^{kmakarp@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Agnieshka Baumritter ; MS^b ; Denise J. Pearson ; COMT^b ; Maxwell Pistilli ; MEd ; MS^a ; Darla Nyquist ; MA ; APRN ; CNP^c ; Michele Huynh ; MS ; ARNP^d ; Kelli Satnes ; MS ; APRN ; CNP^d ; Rachel Keith ; PhD ; MS^e ; Gui-Shuang Ying ; PhD^a ; Graham E. Quinn ; MD ; MSCE^a ; ^b ; for the e-ROP Cooperative Group^&lowast ;
• 刊名：Journal of American Association for Pediatric Ophthalmology and Strabismus
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：20
• 期：3
• 页码：214-219
• 全文大小：487 K

文摘

To report the training/certification process of nonphysician imagers, image quality, and factors that affected image quality in the National Eye Institute sponsored multicentered e-ROP study.

Methods

Nonphysician imagers underwent rigorous training and certification in obtaining retinal images, with attention to clarity, focus, and optic disk placement. Image readers measured pupil size in pupil image and graded posterior pole, temporal, nasal, superior, and inferior retinal images and classified them as good, adequate, poor, or missing. Good and adequate images were deemed acceptable.

Results

In 4,003 image sessions of 1,257 infants, 3,453 (86.8%) were complete. Of 39,550 retinal images, 91.7% had acceptable quality, 5.6% poor, and 2.7% were missing. Inadequate pupil dilation negatively affected acceptable image quality: 54% acceptable images for pupil <5 mm versus 93% for >6 mm (P < 0.0001). When ventilatory equipment obstructed access to imaged infant, the percent of acceptable image quality decreased: 94% for no support versus 66.6% for oscillatory ventilation (P < 0.0001). Acceptable image quality rates improved from 87% to 90% (P = 0.03) from first 6 months to last 6 months at low patient volume centers, while high patient volume centers remained stable at 95%.

Conclusions

Nonphysicians successfully obtained acceptable quality images for ROP evaluation. Skills improved with experience. Image quality was negatively affected by inadequate pupil dilation and the presence of obstructive ventilatory equipment.