Screening for ROP using wide-angle digital retinal photography by non-ophthalmologists
Reviewed by Jonathan Chan

This is a systematic review article to evaluate the accuracy of digital retinal photography (DRP) performed by trained personnel (non-ophthalmologists) in diagnosing clinically significant retinopathy of prematurity (ROP). The authors used search engines including Medline, EMBASE, CINAHL and Cochrane databases. There were in total six studies within the inclusion criteria (three prospective; N=120, three retrospective, N=579). All the eligible studies were assessed using the quality assessment of diagnostic accuracy (QUADAS)-2, an evidence-based tool for the assessment of the quality in systematic reviews of diagnostic accuracy studies. Because of the heterogeneity of the studies, data could not be pooled to derive single-effect size estimates for sensitivity and specificity. However, the included studies reported sensitivity of 45.5-100% with the majority being more than 90%; specificity 61.7-99.8% with the majority being more than 90%, positive predictive value was 61.5-96.6% and negative predictive value was 76.9-100% for diagnosing clinically significant ROP. The authors concluded that the ROP imaging diagnostic accuracy must be established in a larger sample size in prospective multicentre trials where the ROP is compared simultaneously against the performed reference of standard binocular indirect ophthalmoscopy examination. 

Screening for retinopathy of prematurity (ROP) using wide-angle digital retinal photography by non-ophthalmologists: a systematic review.
Athikarisamy SE, Patole S, Lam GC, et al.
BRITISH JOURNAL OF OPHTHALMOLOGY
2015;99:281-8.