Telemedicine screening for diagnosis of retinopathy of prematurity in clinical practice

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Abstract

Purpose

To compare the Retcam Shuttle used in telemedicine and performed by a non-ophthalmologist with the “gold standard” of binocular indirect ophthalmoscopy performed by a referent ophthalmologist for the diagnostic of retinopathy of prematurity.

Methods

Retrospective analysis of the archival data gathered in 18 months between 1 May 2011 and 1 November 2012 in two centers: one practicing telemedicine and one using indirect ophthalmoscopy. The same ophthalmologist was reading the images obtained by Retcam in the first center and performing the fundus examination in the other center. A total of 255 infants were examined, 74 by Retcam and 181 by indirect ophthalmoscopy, resulting in 570 examinations (141 and 429 respectively).

Results

The mean birth weight of the infants was 1300 grammes (SD 340 grammes) in the center practicing telemedicine and 1130 grammes (SD 440 grammes) in the center using indirect ophthalmocopy. The mean gestational age were 28 weeks (SD 12 days) and 27 weeks (SD 19 days) respectively. A total of 1.8 examinations per infant were performed in the center practicing telemedicine, 2.4 in the other one. Retinopathy of prematurity was diagnosed in 13% of infants of the center using telemedicine and 20% of the other one.

Conclusion

Telemedicine can be useful to diagnose retinopathy of prematurity especially in remote areas but it seems to have a lack of sensibility. A very tiny collaboration between the center practicing telemedicine and the ophthalmologist should be sought to improve the results of screening.

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