Abstract
Purpose :
Retinopathy of Prematurity (ROP) is the worldwide leading cause of preventable childhood blindness. In remote areas of the United States as well as developing countries, in-person screening for ROP by a trained ophthalmologist can be a significant hurdle. In this study, we aim to assess the effectiveness of telemedicine screening for retinopathy of prematurity (ROP) in premature infants in South Dakota.
Methods :
A retrospective review of medical records for premature infants were screened for ROP at neonatal intensive care units (NICUs) in Sioux Falls, South Dakota from September 1, 2017 to December 31, 2021. RetCam Shuttle (Natus Medical Inc., Pleasanton, CA) retinal images were posted on a secure server for evaluation by a pediatric ophthalmologist. Patients who were suspected to progress to Stage I ROP or greater were referred to Children’s Hospital and Medical Center in Omaha, Nebraska where they received comprehensive examination and, if necessary, anti-vascular endothelial growth factor (VEGF) treatment. The remaining patients received an outpatient comprehensive examination by a pediatric ophthalmologist within two weeks of discharge.
Results :
250 telemedicine examinations were performed on 70 infants during the study period, averaging 3.6 examinations per infant. Of the 70 infants, 6 (8.6%) were transferred for referral-warranted ROP. Remote telemedicine screening for referral-warranted ROP had a sensitivity of 100% and specificity of 97%. We had a positive predictive value of 67% and negative predictive value of 100%. Four of the six infants transferred for referral-warranted ROP required treatment with anti-VEGF, all of whom had good outcomes. No patients progressed beyond stage 3 ROP.
Conclusions :
Remote telemedicine screening in at-risk premature infants detected referral-warranted ROP at a high accuracy with no poor outcomes throughout the four-year period. This study demonstrates the efficacy and functionality of telemedicine in screening for ROP and lays out implications for further utility in developing countries.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.