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Acute Retinopathy of Prematurity (ROP). Evaluation of Wide-angle Fundus Images with the use of a Dynamic Grid

1Elflein H., 1Lorenz B., 2Pisinger G.,
1Universität Regensburg, Klinik und Poliklinik für Augenheilkunde, Abt. für Pädiatrische Ophthalmologie, Strabismologie und Ophthalmogenetik (Regensburg)
2Bayerisches Forschungszentrum für Wissensbasierte Systeme (ForWiss) , Universität Passau (Passau)

Purpose: Documentation of ROP as a basis for timing of treatment is challenging for the examiner. At the time of ophthalmoscopy the examiner has to decide about the zone and stage of the disease in accordance with the International Guidelines1.
Methods: For a new Screening of preterm babies based on telemedicine the digital widefieldcamera RetCam 120 is employed in 5 NICUs in Eastern and Northern Bavaria. Within one year 215 preterm babies at risk according to actual German recommendations2 were examined. By using a newly developed software a grid can be superimposed on the fundusimages, adjustable to the respective geometry of the eye. The grid corresponds to the international classification of ROP.
Results: The boundary of retinal vascularisation the does not run circulary. Particulary in the temporal periphery the disease often is more central, up and down on the other hand it is more peripheral. Often the extension of zone 1 in the nasal periphery is underestimated.
Conclusions: Evaluation of wide angle fundus images by using a dynamic grid allows an objective evaluation of ROP as to the zones and the spread of the disease and thereby a more precise description of the disease.
1An international classification of retinopathy of prematurity. The Committee for the Classification of Retinopathy of Prematurity. Arch Ophthalmol. 1984 Aug;102(8):1130-4.
2Clemens S, Eckardt C, Gerding H, Grote A, Jandeck C, Kellner U, Lorenz B, Petersen J, Seiberth V, Stark N, Ulbig MW, Zubcov A, Jorch G, Pohlandt F. Augenärztliche Screening-Untersuchung von Frühgeborenen. Ophthalmologe 1999 Apr;96(4):257-63