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Background/aims: To assess accuracy of telemedical retinopathy of prematurity (ROP) diagnosis by trained non-expert graders compared with expert graders., Methods: Eye examinations (n=248) from 67 consecutive infants were captured using wide-angle retinal photography (RetCam-II, Clarity Medical Systems, Pleasanton, California, USA). Non-expert graders attended two 1-h training sessions on image-based ROP diagnosis. Using a web-based telemedicine system, 14 non-expert and three expert graders provided a diagnosis for each eye: no ROP, mild ROP, type 2 pre-threshold ROP or treatment-requiring ROP. All diagnoses were compared with a reference standard of dilated indirect ophthalmoscopy by an experienced paediatric ophthalmologist., Results: For detection of type 2 or worse ROP, the mean (range) sensitivities and specificities were 0.95 (0.94-0.97) and 0.93 (0.91-0.96) for experts, 0.87 (0.71-0.97) and 0.73 (0.39-0.95) for resident non-experts, and 0.73 (0.41-0.88) and 0.91 (0.84-0.96) for student non-experts, respectively. For detection of treatment-requiring ROP, the mean (range) sensitivities and specificities were 1.00 (1.00-1.00) and 0.93 (0.88-0.96) for experts, 0.88 (0.50-1.00) and 0.84 (0.71-0.98) for resident non-experts, and 0.82 (0.42-1.00) and 0.92 (0.83-0.97) for student non-experts, respectively., Conclusions: Mean sensitivity and specificity of trained non-experts were lower than that of experts, although several non-experts had high accuracy. Development of methods for training non-expert graders may help support telemedical ROP evaluation.

Background/aim: A lack of data exists concerning the development of late postoperative, non-proliferative vitreoretinopathy (PVR), rhegmatogenous retinal detachments (RRDs) after successful posterior segment intraocular foreign body (PSIOFB) removal. The authors present a series of PSIOFB cases over several years with posterior hyaloid separation resulting in RRD in two patients, 4 and 8 months after initial injury and vitrectomy. This report aims to increase awareness concerning the possibility of late RRDs complicating PSIOFB injuries and to emphasise careful long term observation., Methods: Medical records of consecutive cases referred for presumed PSIOFB injury during a 4 year period were retrospectively reviewed. All eyes referred for presumed PSIOFB injuries were included., Results: 11 patients were included in the series. Two patients had eyes so badly injured by large PSIOFBs that primary globe closure was followed within days by enucleation. Nine patients underwent pars plana vitrectomy for PSIOFB removal. Two patients experienced late RRDs that were managed with excellent long term visual outcomes., Conclusions: Late RRD may occur following successful removal of PSIOFBs, even several months after initial management. These RRDs may be successfully managed with a variety of methods, depending upon the extent and location of the detachment and causative break as well as surgeon comfort and preference.

Aim: A cross sectional (prevalence) study was performed to assess the usefulness and sensitivity of commonly employed criteria to identify infants for routine ophthalmoscopic screening for retinopathy of prematurity (ROP)., Methods: At a tertiary care centre between 1 January 1992 and 30 June 1998, experienced vitreoretinal specialists screened 438 premature infants for ROP. Retinal maturity and the presence of ROP were determined by indirect ophthalmoscopic examinations., Results: Of the eligible infants surviving 28 days, 276 (91.7%) of 301 infants with birth weights