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Brett Andrew Begley, Donny W Suh; Evaluation of a remote telemedicine screening system for severe retinopathy of prematurity. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3616.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the validity of remote telemedicine screening for retinopathy of prematurity (ROP) in an at-risk preterm infant population in Iowa and South Dakota.
Medical records of all preterm infants screened for ROP at neonatal intensive care units in Sioux City, Iowa, and Sioux Falls, South Dakota, from September 1, 2017 to July 31, 2018, were retrospectively reviewed. The RetCam Shuttle system was used to capture retinal images, which were posted on a secure server for evaluation by a pediatric ophthalmologist. Infants who appeared to have ROP approaching the criteria for treatment with anti-vascular endothelial growth factor (VEGF) medications were transferred to the Children’s Hospital and Medical Center NICU in Omaha, Nebraska, where a comprehensive examination was performed and treatment administered when indicated. All other infants received an outpatient comprehensive examination by one of 2 pediatric ophthalmologists within 2 weeks of discharge.
A total of 124 telemedicine examinations were performed on 35 infants during the study period. Remote telemedicine screening for referral-warranted ROP using the RetCam Shuttle had a sensitivity of 100%, specificity of 97.0%, positive predictive value of 66.7%, and negative predictive value of 100%. Out of 3 infants transferred for referral-warranted ROP, 2 ultimately required treatment with anti-VEGF medications. In all cases, good outcomes were noted, and none progressed beyond stage 3 ROP.
Telemedicine screening reliably detected referral-warranted ROP in at-risk premature infants at 2 remote sites with no poor outcomes over an 11-month period. These results demonstrate the validity and utility of remote telemedicine screening for ROP.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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