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Purpose:To develop a sensitive scale of iris transillumination suitable for clinical and research use, with the capability of either quantitative analysis or visual matching of images. Methods:Iris transillumination photographic images were used from 70 study subjects with ocular or oculocutaneous albinism. Subjects represented a broad range of ocular pigmentation. A subset of images was subjected to image analysis and ranking by both expert and nonexpert reviewers. Quantitative ordering of images was compared with ordering by visual inspection. Images were binned to establish an 8-point scale. Ranking consistency was evaluated using the Kendall rank correlation coefficient (Kendall’s tau). Visual ranking results were assessed using Kendall’s coefficient of concordance (Kendall’sW) analysis. Results:There was a high degree of correlation among the image analysis, expert-based and non-expert-based image rankings. Pairwise comparisons of the quantitative ranking with each reviewer generated an average Kendall’s tau of 0.83 ± 0.04 (SD). Inter-rater correlation was also high with Kendall’sWof 0.96, 0.95, and 0.95 for nonexpert, expert, and all reviewers, respectively. Conclusions:The current standard for assessing iris transillumination is expert assessment of clinical exam findings. We adapted an image-analysis technique to generate quantitative transillumination values. Quantitative ranking was shown to be highly similar to a ranking produced by both expert and nonexpert reviewers. This finding suggests that the image characteristics used to quantify iris transillumination do not require expert interpretation. Inter-rater rankings were also highly similar, suggesting that varied methods of transillumination ranking are robust in terms of producing reproducible results. [ABSTRACT FROM PUBLISHER]

Objectives: To investigate whether there is an association between congenital heart disease (CHD) and placental abnormalities. Methods: We conducted a case ‐ control study that included cases of infants with CHD who underwent cardiac surgery within 6 months of life at the Johns Hopkins Medical Center from 2000 to 2013, and gestational age ‐ matched normal pregnancy controls (200 neonates per group). Results: Overall, abnormal placental cord insertion (ie, eccentric, marginal, or velamentous) was associated with CHD (odds ratio, 2.33–3.76). The main cardiac defects associated with abnormal cord insertion were conotruncal defects (relative risk, 3.08; 95% confidence interval [CI], 1.48–6.40; P = .003), left heart disease (relative risk, 2.40; 95% CI, 1.32–4.37; P = .004), and right heart disease (relative risk, 2.22; 95% CI, 1.21–4.07; P = .010). The Placenta ‐ to ‐ birth weight ratio was not associated with CHD. Intrauterine growth restriction was associated with CHD (odds ratio, 3.00; 95% CI, 1.41–6.39; P = .004). Conclusions: Abnormal cord insertion, as well as intrauterine growth restriction, was determined to be correlated with the presence of CHD. On the basis of our results, we conclude that cord insertion should be evaluated at routine obstetric sonography, and further fetal heart evaluation is warranted if abnormal cord insertion is detected. [ABSTRACT FROM AUTHOR]