Abstract
Purpose: :
To report the 2 year experience of the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) telemedicine initiative.
Methods: :
Retrospective analysis of the SUNDROP archival data. Inclusive dates for this study were 12/1/05 through 11/30/2007 at 4 participating hospitals. All patients screened at least one time using the RetCam II and evaluated by the SUNDROP reading center at Stanford University were included. Nurses were trained to obtain 6 images in each eye. The goal was to obtain 12 total images per patient. Outcomes included referral-warranted disease, need for treatment, and anatomic outcomes. Referral-warranted disease was defined as any Early Treatment Retinopathy of Prematurity Disease Type 2 or greater or any plus disease. All patients were screened by the author within one week of discharge from the neonatal intensive care unit.
Results: :
In the initial 2 years, the SUNDROP telemedicine screening initiative has not missed any referral warranted disease. A total of 131 infants were imaged. Seven infants were identified for referral-warranted disease; six patients underwent laser photocoagulation and regressed. One patient regressed without treatment. The calculated sensitivity was 100%, with specificity of 99.2%. The positive predictive value was 85.7% and negative predictive value was 100%. No patient progressed to retinal detachment or other adverse outcome. For patients needing treatment, the average birthweight was 692 grams, average estimated gestational age was 25 1.5/7 weeks, and average number of exams prior to treatment was 6.2. The average postmenstrual age at treatment was 35 2.2/7 weeks.
Conclusions: :
The SUNDROP telemedicine screening programs for retinopathy of prematurity has proven to have high degree of sensitivity and specificity for identification of referral warranted disease. All cases of referral warranted disease were captured. There were no adverse outcomes.
Keywords: retinopathy of prematurity • clinical (human) or epidemiologic studies: health care delivery/economics/manpower • retina