April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
Speed of Telemedicine versus Ophthalmoscopy for Retinopathy of Prematurity Diagnosis
R. V. Chan; G. M. Richter; G. Sun; T. C. Lee; J. T. Flynn; J. Starren; M. F. Chiang
Author Affiliations & Notes
  • R. V. Chan
    Ophthalmology, Weill Cornell Medical College, New York, New York
  • G. M. Richter
    Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York
  • G. Sun
    Ophthalmology, Weill Cornell Medical College, New York, New York
  • T. C. Lee
    Ophthalmology, The Vision Center, Childrens Hospital Los Angeles, New York, New York
  • J. T. Flynn
    Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York
  • J. Starren
    Biomedical Informatics Research Center, Marshfield Clinic, Marshfield, Wisconsin
  • M. F. Chiang
    Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York
  • Footnotes
    Commercial Relationships  R.V. Chan, None; G.M. Richter, None; G. Sun, None; T.C. Lee, None; J.T. Flynn, None; J. Starren, None; M.F. Chiang, Unpaid Member of the Scientific Advisory Board for Clarity Medical Systems (Pleasanton, CA), C.
  • Footnotes
    Support  NIH Grant EY13972 (MFC), Research to Prevent Blindness Career Development Award (MFC), St. Giles Foundation (RVPC), T.J. Martell Foundation (TCL)
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 3146. doi:
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      R. V. Chan, G. M. Richter, G. Sun, T. C. Lee, J. T. Flynn, J. Starren, M. F. Chiang; Speed of Telemedicine versus Ophthalmoscopy for Retinopathy of Prematurity Diagnosis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3146.

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Abstract

Purpose: : To compare the speed of ROP diagnosis using standard indirect ophthalmoscopy to that of telemedicine.

Methods: : Prospective comparative study. 3 study examiners (2 pediatric retinal specialists, 1 pediatric ophthalmologist) conducted ROP diagnosis via standard indirect ophthalmoscopy and telemedicine. Each examiner performed: (1) standard ophthalmoscopy on 72-150 consecutive infants at his respective institution, and (2) telemedical diagnosis on de-identified retinal image sets of 125 infants. Time for ophthalmoscopic diagnosis was measured in two ways: (a) time spent by examiner at the infant bedside, and (b) mean total time commitment per infant. Time for telemedicine diagnosis was recorded by computer timestamps in the web-based system. For each examiner, non-parametric statistical analysis (Mann-Whitney) was used to compare the distribution of times for examination by ophthalmoscopy versus telemedicine.

Results: : Mean (±SD) times for ophthalmoscopic diagnosis by the three examiners ranged from 4.17 (±1.34) minutes to 6.63 (±2.28) minutes per infant. Mean (±SD) times for telemedicine diagnosis ranged from was 1.02 (±0.27) minutes to 1.75 (±0.80) minutes per infant. Telemedicine was significantly faster than ophthalmoscopy (p<0.0001). The total time commitment by ophthalmologists performing bedside ophthalmoscopy for ROP diagnosis, including travel and communication with families and hospital staff, was 10.08 (±2.53) minutes to 14.42 (±2.64) minutes per infant.

Conclusions: : The ophthalmologist time requirement for telemedical ROP diagnosis is significantly less than for ophthalmoscopic diagnosis. Additional time requirements associated with bedside ROP diagnosis increased this disparity. Telemedicine has potential to alleviate the time commitment for ophthalmologists who manage ROP.

Keywords: retinopathy of prematurity • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: systems/equipment/techniques 
© 2009, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2015 Association for Research in Vision and Ophthalmology.
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