Telemedicine Effective in Retinopathy of Prematurity Screening
Telemedicine is a valid means of screening for retinopathy of prematurity (ROP), reports a new study in JAMA Ophthalmology. The research was funded by the National Eye Institute.
The observational study was conducted on 1,257 premature infants starting at 32 weeks' postmenstrual age with birth weight <1251g in 13 neonatal intensive care units (NICUs) in North America from May 25, 2011 through October 31, 2013. The infants were screened by an ophthalmologist approximately every nine days for assessment on treatment referrals. Those referred were designated as having referral-warranted ROP (RW-ROP). Immediately prior to or following the evaluation, a non-physician staff member in the NICU captured images of the infant's retinas and sent them to a secure server where trained non-physician image readers conducted independent evaluations following a standard protocol for detecting the presence or absence of RW-ROP.
Characteristics of RW-ROP was identified in 19.4% of the infants. Non-physician image evaluation an eye at single session had sensitivity of 81.9% (95% CI, 77.4–85.6) and specificity of 90.1% (95% CI, 87.9–91.8). The sensitivity was 90.0% when both eyes were considered for the presence of RW-ROP (95% CI, 85.4–93.5), with specificity of 87.0% (95% CI, 84.0–89.5).
The American Academy of Ophthalmology recommends routine ROP screening for all infants born at gestational age ≤30 weeks or who weigh <3.3lbs at birth. Telemedicine may assist in early detection of RW-ROP, as 43% of advanced ROP cases were identified by telemedicine prior to detection by an ophthalmologist in the study. Weekly ROP screening may be feasible with telemedicine and assist in detecting all cases where treatment is needed, state the authors.
For more information visit NIH.gov.