SmartPlus: a computer-based image analysis method to predict continuous-valued vascular abnormality index in Retinopathy of Prematurity

Abstract Plus disease is characterized by abnormal changes in retinal vasculature of premature infants. Presence of Plus disease is an important criterion for identifying treatment-requiring cases in Retinopathy of Prematurity (ROP). However, diagnosis of Plus disease has been shown to be subjective...

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Main Authors: Sayed Mehran Sharafi, Nazanin Ebrahimiadib, Ramak Roohipourmoallai, Afsar Dastjani Farahani, Marjan Imani Fooladi, Golnaz Gharehbaghi, Elias Khalili Pour
Format: Article
Language:English
Published: BMC 2025-04-01
Series:International Journal of Retina and Vitreous
Online Access:https://doi.org/10.1186/s40942-025-00668-3
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author Sayed Mehran Sharafi
Nazanin Ebrahimiadib
Ramak Roohipourmoallai
Afsar Dastjani Farahani
Marjan Imani Fooladi
Golnaz Gharehbaghi
Elias Khalili Pour
author_facet Sayed Mehran Sharafi
Nazanin Ebrahimiadib
Ramak Roohipourmoallai
Afsar Dastjani Farahani
Marjan Imani Fooladi
Golnaz Gharehbaghi
Elias Khalili Pour
author_sort Sayed Mehran Sharafi
collection DOAJ
description Abstract Plus disease is characterized by abnormal changes in retinal vasculature of premature infants. Presence of Plus disease is an important criterion for identifying treatment-requiring cases in Retinopathy of Prematurity (ROP). However, diagnosis of Plus disease has been shown to be subjective and there is wide variability in the classification of Plus disease by ROP experts, which is mainly because experts have different cut-points for distinguishing the levels of vascular abnormality. This suggests that a continuous Plus disease severity score may reflect more accurately the behavior of expert clinicians and may better standardize the classification. The effect of using quantitative methods and computer-based image analysis to improve the objectivity of Plus disease diagnosis have been well established. Nevertheless, the current methods are based on categorical classifications of the disease severity and lack the compatibility with the continuous nature of the abnormal changes in retinal vasculatures. In this study, we developed a computer-based method that performs a quantitative analysis of vascular characteristics associated with Plus disease and utilizes them to build a regression model that outputs a continuous spectrum of Plus severity. We evaluated the proposed method against the consensus diagnosis made by four ROP experts on 76 posterior ROP images. The findings of our study indicate that our approach demonstrated a relatively acceptable level of accuracy in evaluating the severity of Plus disease, which is comparable to the diagnostic abilities of experts.
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spelling doaj-art-5bc8ef2d380444cc935e75fe3ad61a912025-08-20T02:12:02ZengBMCInternational Journal of Retina and Vitreous2056-99202025-04-0111111010.1186/s40942-025-00668-3SmartPlus: a computer-based image analysis method to predict continuous-valued vascular abnormality index in Retinopathy of PrematuritySayed Mehran Sharafi0Nazanin Ebrahimiadib1Ramak Roohipourmoallai2Afsar Dastjani Farahani3Marjan Imani Fooladi4Golnaz Gharehbaghi5Elias Khalili Pour6Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical SciencesOphthalmology Department, College of Medicine, University of FloridaDepartment of Ophthalmology, Morsani College of Medicine, University of South FloridaRetinopathy of Prematurity Department, Farabi Eye Hospital, Tehran University of Medical SciencesClinical Pediatric Ophthalmology Department, UPMC, Children’s Hospital of PittsburghDepartment of Pediatrics, Ali Asghar Children’s Hospital, Iran University of Medical SciencesRetinopathy of Prematurity Department, Farabi Eye Hospital, Tehran University of Medical SciencesAbstract Plus disease is characterized by abnormal changes in retinal vasculature of premature infants. Presence of Plus disease is an important criterion for identifying treatment-requiring cases in Retinopathy of Prematurity (ROP). However, diagnosis of Plus disease has been shown to be subjective and there is wide variability in the classification of Plus disease by ROP experts, which is mainly because experts have different cut-points for distinguishing the levels of vascular abnormality. This suggests that a continuous Plus disease severity score may reflect more accurately the behavior of expert clinicians and may better standardize the classification. The effect of using quantitative methods and computer-based image analysis to improve the objectivity of Plus disease diagnosis have been well established. Nevertheless, the current methods are based on categorical classifications of the disease severity and lack the compatibility with the continuous nature of the abnormal changes in retinal vasculatures. In this study, we developed a computer-based method that performs a quantitative analysis of vascular characteristics associated with Plus disease and utilizes them to build a regression model that outputs a continuous spectrum of Plus severity. We evaluated the proposed method against the consensus diagnosis made by four ROP experts on 76 posterior ROP images. The findings of our study indicate that our approach demonstrated a relatively acceptable level of accuracy in evaluating the severity of Plus disease, which is comparable to the diagnostic abilities of experts.https://doi.org/10.1186/s40942-025-00668-3
spellingShingle Sayed Mehran Sharafi
Nazanin Ebrahimiadib
Ramak Roohipourmoallai
Afsar Dastjani Farahani
Marjan Imani Fooladi
Golnaz Gharehbaghi
Elias Khalili Pour
SmartPlus: a computer-based image analysis method to predict continuous-valued vascular abnormality index in Retinopathy of Prematurity
International Journal of Retina and Vitreous
title SmartPlus: a computer-based image analysis method to predict continuous-valued vascular abnormality index in Retinopathy of Prematurity
title_full SmartPlus: a computer-based image analysis method to predict continuous-valued vascular abnormality index in Retinopathy of Prematurity
title_fullStr SmartPlus: a computer-based image analysis method to predict continuous-valued vascular abnormality index in Retinopathy of Prematurity
title_full_unstemmed SmartPlus: a computer-based image analysis method to predict continuous-valued vascular abnormality index in Retinopathy of Prematurity
title_short SmartPlus: a computer-based image analysis method to predict continuous-valued vascular abnormality index in Retinopathy of Prematurity
title_sort smartplus a computer based image analysis method to predict continuous valued vascular abnormality index in retinopathy of prematurity
url https://doi.org/10.1186/s40942-025-00668-3
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