April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Telemedicine for ROP Screening
Author Affiliations & Notes
  • Michael Thomas Trese
    Associated Retinal Consultants, Royal Oak, MI
    William Beaumont Hospital, Royal Oak, MI
  • Kimberly Drenser
    Associated Retinal Consultants, Royal Oak, MI
    William Beaumont Hospital, Royal Oak, MI
  • Antonio Capone
    Associated Retinal Consultants, Royal Oak, MI
    William Beaumont Hospital, Royal Oak, MI
  • Footnotes
    Commercial Relationships Michael Trese, Focus ROP (S), Genentech (R), Nu-Vue Technologies (S), Retinal Solutions (S), Synergetics (R), ThromboGenics (S); Kimberly Drenser, Allergan (R), Focus ROP (S), Retinal Solutions (S), Synergetics (R), ThromboGenics (S); Antonio Capone, Allergan (R), Focus ROP (S), Retinal Solutions (S), Synergetics (R), ThromboGenics (S)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5905. doi:
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      Michael Thomas Trese, Kimberly Drenser, Antonio Capone; Telemedicine for ROP Screening. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5905.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Retinopathy of prematuity screening is the key element for good ROP care allowing well timed treatment which can result in highly successful results from laser and early vitrectomy treatment. Customarily ROP screening has been done by doctors doing on average at our institution 6 exam per baby prior to discharge from the NICU. ROP is a very serious disease but only about 18% of eyes require treatment by a physician. In addition bedside exams are often documented by retinal drawing by the doctor which can lead to human error. A photograph can be studied and shared with accuracy with the neonatologist, NICU staff, and parents, and sent for remote readings by skilled readers in any location avoiding travel time for the examiner and time in the nursery. Handling of images must follow privacy laws and provide accurate representation of retinal findings that trigger bedside exam and treatment. It has been proven in several studies that telemedicine can transfer images accurately, but software also can be designed to reduce human error.

 
Methods
 

FocusROP software was designed to reduce human error in two areas of telemedicine, as well as reducing the need for doctor time doing ROP examinations in the NICU, thereby reducing cost of ROP screening and providing photographic documentation. Two areas of potential human error are image uploading by the NICU nurse and, for doctors, timing of the next examination as ROP is very time sensitive. Exams that extend the next exam by only a few weeks can result in a disasterous sequence of events and missing a treatment interval. The FocusROP software overcomes these issues by using an oriented upload pattern that makes erroneous image loading less possible, and the examination schedual is fixed based on the observed findings and randomized study recommendations and not changeable by the doctor, therefore error in exam schedule is not possible. We have used this system in a two hospital system for 3 years, well over 2 500 exams.

 
Results
 

We have reduced the indicated doctor preformed bedside exams by 84% and no baby has missed a treatment interval. After instruction there were only 10 uploading errors by NICU nurses.

 
Conclusions
 

Photographic documentation and telemedicine management of ROP care with intelligent software can provide better documentation, safer screening, and less doctor time going to and in the NICU therefore reducing cost of ROP screening . Telemedicine for ROP is the future of screening for ROP.

 
Keywords: 706 retinopathy of prematurity • 698 retinal development • 697 retinal detachment  
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