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HM Elflein, B Lorenz, MN Preising, G Pisinger; Telemedicine in Acute ROP: A Multicenter Study Using a Digital Retinal Imaging System . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1243.
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Purpose: Prospective study to evaluate the potential of the RetCam120 in detecting acute ROP in a remote setting. Methods: RetCams were installed in five NICUs in Eastern Bavaria by February 2001. Since then all premature infants at risk1 were examined both with a RetCam120 and ophthalmoscopically. The project has been approved by the Ethical Committee of the University, and informed consent was given at each instance. In the 4 NICUs outside Regensburg, the screening was performed by the local ophthalmologists. The images were sent to the Reading Centre at the Dept. of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, Regensburg. In the Reading Centre, all images were analysed independently by at least 2 ophthalmologists to evaluate sensitivity and specificity compared to indirect ophthalmoscopy. Further a software has been developed for exact definition of the retinal zones by using a grid adjustable according to the individual disk-macula distance. Results: By November 30, 160 children have been examined, 5 needed treatment. No zone I or zone II disease, and in particular no threshold disease was missed. Estimation of extraretinal proliferations required some experience. By using the grid pattern, the non circular location of the disease could be quantified. Initial problems with handling of the camera were transitory. Pupillary dilation was critical, and the retina peripheral to the equator was imaged only with low contrast. Maximal pupillary dilation and some exercise in handling the camera visualized also zone III . Cooperation with the medical staff in the NICU's and the general ophthalmologists was generally good, and the project found the approval of the children's parents. Conclusion: The Retcam 120 combined with telemedicine appears to have the potential to detect all acute ROP cases requiring treatment, and to overcome examiner dependent differences in expertise. 1Clemens S, Eckardt C, Gerding H, Grote A, Jandeck C, Kellner U, Lorenz B, Petersen J, Seiberth V, Stark N, Ulbig MW, Zubcov A, Jorch G, Pohlandt F. Augenärztliche Screening-Untersuchung von Frühgeborenen. Ophthalmologe 1999 Apr;96(4):257-63
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