Safety and Feasibility of Tele-Screening for Retinopathy of Prematurity
Nasser Shoeibi1 *, Seyedeh Maryam Hosseini1 , Mohammadreza Ansari1 , Mojtaba Abrishami1 , Mehrdad Motamed Shariati1 , Ghodsie Zamani1 , Fatemeh Neghabi2
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Khatam Eye hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract: To evaluate the use of remote reading of digital retinal photographs in the diagnosis of severe (treatment-warranted) retinopathy of prematurity (ROP) during longitudinal screening for ROP in NICUs not accessing bedside ophthalmology exam.
Methods: According to ROP standard timelines, infants were examined longitudinally, over a series of examinations, by digital photography using the RetCam-120 Digital Retinal Camera (Massie Research Laboratories Inc., Dublin, CA) from July 2020 to April 2021. Images were transferred in a web-based route to ROP reading center in a tertiary ophthalmology hospital to be interpreted by trained vitreoretinal surgeons. Treatment warranted ROP was defined as the presence of plus disease or the presence of any stage 3 ROP. Treatment with intravitreal bevacizumab was done in NICU. All patients were examined bedside after discharge from NICU at the referral ROP center.
Results: A total number of 2537 exams were done for 1213 patients (1-11, median 2). The mean birth age of the patients was 30 weeks (24-41) and the mean birth weight was 1351 grams (550-4900). Severe (treatment-warranted) ROP was diagnosed in 100 eyes (53 patients) during admission in NICU. The mean birth age of the treatment-warranted patients was 27 weeks (25-30) and the mean birth weight was 992 grams (550-1700). Intravitreal injection of bevacizumab was performed in NICU. In the final bedside clinical exam in the referral ophthalmic center, no case of advanced ROP was recognized. Tele-screening had a 100% sensitivity in diagnosing treatment-needed ROP.
Conclusion: This study showed that longitudinal remote reading of digital photographs using the RetCam-120 system has excellent sensitivity in detecting treatment-warranted ROP.
