Comparison of expert graders to computer-assisted image analysis of the retina in retinopathy of prematurity

Abstract

AIMS: To determine correlation of width and tortuosity between expert graders and computer-assisted image analysis of the retina in narrow-field images of eyes with retinopathy of prematurity. METHODS: 11 digital images were selected based on severity of retinopathy of prematurity (ROP). Narrow field images were analysed for width and tortuosity of vessels using computer-aided image analysis of the retina (CAIAR), an image analysis software, and by four ROP experts. Spearman correlation coefficients (ρ) assessed the correlation of CAIAR grading with expert grading. Intra-class correlations assessed agreement among graders. Width and tortuosity were compared among severity of ROP and treatment status using analysis of variance and generalised estimating equations. RESULTS: Expert measurements correlated well with measures from CAIAR for venule width (ρ=0.57-0.66) and arteriole tortuosity (ρ=0.71-0.81). Measurements from four graders agreed moderately well (intra-class correlations were 0.49 and 0.69 for venule width and arteriole tortuosity, respectively). Increased severity of ROP (no pre-plus/plus, pre-plus, plus) was associated with larger width (linear trend p=0.02 in two graders) and tortuosity (linear trend p<0.03 in all graders). Tortuosity measurements by CAIAR and graders were statistically different between treated and untreated eyes (p<0.002). CONCLUSIONS: We found moderate correlation between expert graders' assessment of vessel tortuosity and width and CAIAR using narrow-field images.