Purchase this article with an account.
Agnieshka Baumritter, e-ROP Cooperative Group; Training and Certification of Retinal Imagers in the Telemedicine Approaches to evaluating acute-phase Retinopathy of Prematurity (e-ROP) Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):977.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The current approach for detecting serious retinopathy of prematurity (ROP) in infants at risk requires an examination by an ophthalmologist with experience in ROP. Such expertise is in short supply and comes with a high cost, and therefore alternative approaches are needed. <br /> We describe the training and certification process for obtaining ROP digital images by non-physician Certified Retinal Imagers (CRI) in the multicenter Telemedicine Approaches to evaluating acute-phase Retinopathy of Prematurity (e-ROP) Study.
Non-physicians were trained to obtain a standard set of retinal images including disc central, disc right, disc left, disc up, and disc down by using the RetCam Shuttle (Clarity, Pleasanton, CA), a wide field imaging camera system (with 130° lens). The backgrounds of CRIs varied including NICU nurses, neonatal nurse practitioners, ophthalmic photographers, ocular coherent tomographers, and ophthalmic technologists. Certification consisted of onsite instruction by an experienced retinal imager from Clarity, hands on training during the Technical Group meeting, submitting a series of 3 sets of 6 images each to the e-ROP Reading Center for review and resubmission until satisfactory, a visit from the Office of Study Chair to evaluate imaging on site, and completion of a series of knowledge assessments. Quality and completeness of images was monitored throughout the Study duration.
Twenty six non-physician imagers in 12 clinical centers were certified as CRIs for the Study. They obtained 7905 gradable image sets. The completeness of image sets increased with experience (10.4% incomplete during first 6 months vs 5.9% during last 6 months, p<0.001). Also, the quality of images improved with experience (89% gradable during first 6 months vs 93% during last 6 months).
Non-physicians can be successfully trained and certified for obtaining retinal images from infants with birth weights of <1251g of sufficient quality for grading in the severe ROP detection telemedicine system.
This PDF is available to Subscribers Only