Telehealth for managing ROP efficient, innovative
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Telehealth for retinopathy of prematurity is the paradigmatic model for asynchronous telemedicine in retina, according to a speaker here.
“Telehealth for retinopathy of prematurity has given a lot of innovations. It has allowed for standardization, objectivity, longitudinal comparison. It has created the mandated screening interval and inclusivity. It opens up the black box and allows us to see what the pediatric retina specialist, pediatric ophthalmologist or general retina specialist at the bedside is doing to identify disease,” Darius M. Moshfeghi, MD, said at the virtual OSN New York meeting.
At-risk patients are identified in a neonatal intensive care unit and screened by a camera, images are sent to a physician, and a decision is made to repeat screening, to treat or both. This process continues until the baby is discharged from the hospital or completes screening criteria, he said.
Screening for ROP is mandatory. Children are screened at 31 weeks of postmenstrual age or 4 weeks of chronological age, whichever is later, he said.
Telehealth uses objective measurements of change and a mandated screening interval, whereas traditional bedside binocular indirect ophthalmoscopy is based on a findings-based interval. Binocular indirect ophthalmoscopy is not scalable or verifiable and is highly variable, Moshfeghi said.
He also noted that Stanford University School of Medicine has been using telemedicine as its ROP screening standard for 15 years, with all statistical metrics approaching 100% for the identification of treatment warranted disease.
“Telemedicine, as viewed through the paradigm of this very paradigmatic disease, retinopathy of prematurity, where we can in a short period of time capture everything from the onset of the disease all the way through end stage and bad outcomes or through treatment intervention or ultimately maturation and discharge, is very effective,” Moshfeghi said.
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Moshfeghi DM. Applications of telemedicine in ophthalmology: Retina specialist’s perspective. Presented at: OSN New York and OSN New York Retina; Oct. 17-18, 2020 (virtual meeting).
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