Wide-field digital imaging based telemedicine for screening for acute retinopathy of prematurity (ROP). Six-year results of a multicentre field study

• DOI: 10.1007/s00417-009-1077-7
• Publication Date: 2009-05-21T20:01:55Z
• Authors: Birgit Lorenz; Katerina Spasovska; Heike Elflein; Nico Schneider
• Keywords: Childhood blindness; Fundus (uterus)

To report on a 6-year experience with wide-field digital imaging based telemedicine (WFDI telemedicine) to reduce the risk for blindness from retinopathy of prematurity (ROP). Wide-angle fundus cameras (RetCam 120, Massie Lab, Pleasanton, CA, USA) were installed in five neonatal intensive care units (NICUs) Germany. All prematures at screened WFDI, and local ophthalmologists asked continue binocular indirect ophthalmoscopy (BIO) according German guidelines. Image data coded transferred Reading Centre Regensburg. evaluation additional BIO infants suspected treatment-requiring ROP (STR-ROP i.e. threshold zone II, prethreshold I (type-1 ETROP), possibly requiring treatment but not reliably classifiable images) performed by paediatric Centre. was classified following ICROP, ETROP, revised ICROP criteria. Outcome measures incidence clinically relevant (CR-ROP, any up mid-peripheral III, ≤ stage 3+), sensitivity detect STR-ROP, positive predictive value (TR-ROP). In total, 1,222 (mean BW 1395 g, SD ±507 g; mean GA 30 wks, ±3 wks). The overall CR-ROP 27.6% (71.8% mild = 1 3 without plus disease, 15.7% type-1 12.5% ICROP). Zone disease present 3.3%, II 76.5%, III 20.2%. According 95 or type-2 ROP; 67.4% ROP, 32.6% ROP. Of all infants, 3.5% received treatment. Following ETROP (not applied study), 5.3% would have been treated. detecting STR-ROP 100%, TR-ROP 82.4% (28/34) time first referral (28 3+ II). detected time, showing potential our telemedical screening program. comparable incidences reported other West European countries.