{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T04:30:39Z","timestamp":1759206639600},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T00:00:00Z","timestamp":1450656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Computer\u2010assisted assessment of vessel tortuosity is clinically useful in retinopathy of prematurity (ROP). However, poor image quality is often prohibitive for accurate segmentation by fully automated systems and semi\u2010automated systems are prone to unreliability. In the present work, we describe a method of retinal vessel tortuosity measurement by means of purpose\u2010built image analysis software that does not require high image quality yet is also reliable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Images were obtained from neonates at risk of ROP with Retcam Shuttle<jats:sup>\u00ae<\/jats:sup>. Individual vessels were assessed with the semi\u2010automated Novel Evidenced Assessment of Tortuosity (NEAT) system by two masked experimenters. Scores were compared to assess reliability. They were also compared against clinical scoring of individual vessels by two ROP screeners to assess relationship with clinical assessment. In a second image cohort, the mean of the most tortuous vessel in each of four quadrants in each eye (NEAT\u2010O) was compared against the documented gold standard clinical grading of plus disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Reliability of the NEAT system for 50 individual vessels using Bland\u2013Altman plots was excellent. NEAT tortuosity scores for 50 individual vessels compared to clinical scoring showed strong correlation (0.706). Correlation between the NEAT\u2010O score for average tortuosity and gold standard for 167 eyes was modest (0.578).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The NEAT system is intuitive, user\u2010friendly and robust enough to be clinically useful in poor\u2010quality images. It allows for a rapid, valid and reliable assessment of tortuosity of individual vessels and produces a tortuosity score that correlates well with severity of plus disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.12907","type":"journal-article","created":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T05:56:47Z","timestamp":1450677407000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Novel Evidenced Assessment of Tortuosity system: interobserver reliability and agreement with clinical assessment"],"prefix":"10.1111","volume":"94","author":[{"given":"Konstantinos","family":"Balaskas","sequence":"first","affiliation":[{"name":"Manchester Royal Eye Hospital Central Manchester University Hospitals NHS Foundation Trust Manchester UK"},{"name":"Centre for Hearing and Vision Research Medical School University of Manchester Manchester UK"},{"name":"Moorfields Eye Hospital NHS Foundation Trust London 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