SUNDROP: six years of screening for retinopathy of prematurity with telemedicine

• Published in: Canadian journal of ophthalmology Vol. 50; no. 2; pp. 101 - 106
• Main Authors: Wang, Sean K., BS, Callaway, Natalia F., MD, MS, Wallenstein, Matthew B., MD, Henderson, Michael T, Leng, Theodore, MD, MS, Moshfeghi, Darius M., MD
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.04.2015
• Subjects: Diagnosis, Computer-Assisted - methods; False Negative Reactions; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Internal Medicine; Male; Neonatal Screening - methods; Ophthalmology; Ophthalmoscopy - methods; Photography - methods; Predictive Value of Tests; Retinopathy of Prematurity - diagnosis; Retrospective Studies; Sensitivity and Specificity; Telemedicine - methods; Vision Screening - instrumentation
• ISSN: 0008-4182; 1715-3360
• DOI: 10.1016/j.jcjo.2014.11.005

Abstract Objective To report the 6-year results of the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) initiative in the context of telemedicine screening initiatives for retinopathy of prematurity (ROP). Design A retrospective analysis. Participants Premature newborns requiring ROP screening at 6 neonatal intensive care units from December 1, 2005, to November 30, 2011. Methods Infants were evaluated via remote retinal photography by an ROP specialist. A total of 608 preterm infants meeting ROP examination criteria were screened with the RetCam II/III (Clarity Medical Systems, Pleasanton, Calif.). Primary outcomes were treatment-warranted ROP (TW-ROP) and adverse anatomical events. Results During the 6 years, 1216 total eyes were screened during 2169 examinations, generating 26 970 retinal images, an average of 3.56 examinations and 44.28 images per patient. Twenty-two (3.6%) of the infants screened met criteria for TW-ROP. Compared with bedside binocular ophthalmoscopy, remote interpretation of RetCam II/III images had a sensitivity of 100%, specificity of 99.8%, positive predicative value of 95.5%, and negative predicative value of 100% for the detection of TW-ROP. No adverse anatomical outcomes were observed for any enrolled patient. Conclusions The 6-year results for the SUNDROP telemedicine initiative were highly favourable with respect to diagnostic accuracy. Telemedicine appears to be a safe, reliable, and cost-effective complement to the efforts of ROP specialists, capable of increasing patient access to screening and focusing the resources of the current ophthalmic community on infants with potentially vision-threatening disease.