Assessment of Agreement in the Diagnosis of Retinopathy of Prematurity between Ophthalmology Residents and Retina Specialists

Abstract Introduction: Retinopathy of prematurity (ROP) screening is usually performed by a retina specialist. However, the trend of rapidly rising incidence of ROP has placed a greater burden on retina specialists. To ease this burden, ophthalmologists without pediatric or retinal subspecialty training may be trained and charged with ROP screening. Purpose: The purpose is to assess the agreement of ROP diagnosis between the retina specialist and the trained senior residents. Materials and Methods: This was a prospective observational study. ROP screening was done by two trained senior residents (SR1 and SR2) and one retina specialist. Results: A total of 300 babies were screened for ROP with a mean gestational age of 32 ± 2.9 weeks. Sensitivity and specificity for diagnosing any stage of ROP by SR1 were 94.7% and 92.3%, respectively, and by SR2 were 94.1% and 91.89%, respectively. Agreement analysis using kappa statistics showed a kappa value of 0.88 between the retina specialist and SR1, 0.86 between the retina specialist and SR2, and 0.91 between SR1 and SR2. Conclusion: General ophthalmologists and residents trained in ROP screening can, therefore, be charged for ROP screening, while retina specialists can utilize their skills in management of ROP.