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Telemedicine may be optimal for screening retinopathy of prematurity
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New data support the validity of remote evaluation by trained nonphysicians for infants at risk of developing retinopathy of prematurity compared with standard diagnostic examinations, according to researchers.
“This study provides validation for a telemedicine approach to ROP screening and could help save thousands of infants from going blind,” lead author Graham E. Quinn, MD, a professor of ophthalmology at the Children’s Hospital of Philadelphia, said in a press release issued by the National Institutes of Health about the study.
Quinn and colleagues conducted an observational study of 1,257 premature infants from 13 North American neonatal ICUs between May 2011 and October 2013. Infants’ mean birth weight was 864 g, and mean gestational age was 27 weeks.
The infants underwent a mean of three scheduled diagnostic examinations by an ophthalmologist. Widefield digital imaging was performed by a nonphysician staff member to evaluate the validity of a telemedicine system in identifying infants who may have severe ROP requiring an evaluation by an ophthalmologist.
Diagnostic data identified referral-warranted ROP characteristics in 18.2% of eyes (19.4% of infants); remote grading of images of an eye at a single session had a sensitivity of 81.9% and specificity of 90.1%. When both eyes were considered, sensitivity was 90% and specificity was 87%, according to the researchers.
For the observed referral-warranted ROP rate of 19.4%, there was a negative predictive value of 97.3% and positive predictive value of 62.5%, Quinn and colleagues found.
Disclosure: Hildebrand reported receiving support from Inoveon Corp., has a patent for Digital Disease Management System, and royalties paid to Inoveon Corp. Ells reports fees from Clarity Medical Systems. All other authors have no relevant financial disclosures.
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