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New research · Ophthalmology
The British journal of ophthalmology · 4d
Cohort studyThe British journal of ophthalmology · 2026

Quantitative reference map of retinopathy of prematurity improves diagnostic reliability and treatment decisions.

Hao Zhou, Limei Sun, Weilu Li … Zhi Xie
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OphthalmologyCohort study

Quantitative reference map raised agreement on retinopathy of prematurity zone classification

Quantitative reference map of retinopathy of prematurity improves diagnostic reliability and treatment decisions.

Hao Zhou … Zhi Xie
The British journal of ophthalmology · 2026
Background

Retinopathy of prematurity (retinopathy of prematurity) zone classification guides disease severity assessment and Early Treatment for Retinopathy of Prematurity (Early Treatment for Retinopathy of Prematurity)-based treatment decisions but remains subjective, particularly in the peripheral retina.

Methods

Four ophthalmologists evaluated 85 retinopathy of prematurity examinations with and without the reference map in a crossover reader study.

n = 85 ROP examinations
Results

reviewers agreed with the reference standard far more often

0.58kappa
Without reference map
0.92kappa
With reference map
More results

In a Zone III versus non-Zone III analysis, reader-reference agreement improved from 0.40 to 0.88.

In 20 zone-dependent Early Treatment for Retinopathy of Prematurity observations, agreement improved from 0.85 to complete concordance within this subset.

“
Conclusion

The quantitative retinopathy of prematurity zone reference map improved reliability of zone classification and supported more consistent Early Treatment for Retinopathy of Prematurity guideline application in this retrospective reader study.

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