Computer-assisted quantification of pre-plus and plus disease in images obtained using Pictor versus video indirect ophthalmoscopy: a pilot study

Subjectivity in the diagnosis of plus disease in retinopathy of prematurity has prompted the creation of computer programs to objectively measure vascular characteristics. ROPtool is a semiautomated computer program that analyzes retinal vascular dilation and tortuosity. To explore its ability to trace images taken with a FDA-approved, portable, handheld noncontact digital fundus camera (Pictor), we compared ROPtool analysis of Pictor still images acquired by nonophthalmologists to video indirect ophthalmoscopy (VIO) still images acquired by ophthalmologists. ROPtool could trace more Pictor versus VIO images. In addition, receiver operating characteristic curves showed that accuracy for diagnosing pre-plus or plus disease was higher using Pictor versus VIO images.