July 27, 2014

Premature infants at risk of serious vision complications can benefit from telemedicinescreenings, says a new study published in JAMA Ophthalmology this week.  Image consultants at a remote location achieved 90% accuracy in identifying infants at high risk of blindness or other complications due to retinopathy of prematurity (ROP), said lead researcher Graham E. Quinn, MD, MSCE, a pediatric ophthalmologist at The Children’s Hospital of Philadelphia, potentially leading to more consistent and effective screenings for premies.
While improved techniques for helping premature babies have raised the survival rate for these children, this has subsequently increased the number of infants experiencing complications from early births throughout their lives.  ROP, an abnormal pattern of growth in the retinal blood vessels, occurs in more than half of infants born at 30 weeks or earlier and may cause blindness in up to 13% of premies.  Only 5% to 8% of ROP cases are severe enough to warrant treatment, but a decrease in pediatric ophthalmologists available to conduct screenings has led healthcare providers to seek alternate methods of care.
Quinn and the e-ROP Cooperative Group, a collaboration of 13 neonatal intensive care units across the country, compared evaluations conducted by ophthalmologists with those provided by specially trained non-physician providers viewing remotely transmitted images of at-risk children. The image readers identified 90% of the infants also identified by a group of ophthalmologists.  Of images missed by the telemedicine specialists, 87% were also not noted by the eye doctors.
“This study provides validation for a telemedicine approach to ROP screening and could help prevent thousands of kids from going blind,” Quinn says. Dedicated remote image specialists can conduct screenings more frequently than ophthalmologists, potentially expanding the number of infants whose vision problems could be treated or prevented and lowering the costs of such screenings.
While hospitals would need to invest in special retinal cameras and infrastructure to transmit images to a centralized telehealth center, “telemedicine potentially gives every hospital access to excellent ROP screening,” Quinn concludes. “Although further investigations must be done before a telemedicine approach can be broadly implemented, this is a very important next step.”

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