The e-ROP Study: Telemedicine for retinopathy of prematurity

Could a technician in philadelphia
prevent a premature baby in Minneapolis from going blind just by looking at photos of the babies
eyes? A new study funded by the National Eye Institute suggests it’s possible. Premature babies are at risk of going blind from a condition called retinopathy of
prematurity, also known as ROP. ROP is treatable but only if it is detected in time. “So if
you detect it you have a good chance and treating it and
with treatment you have a good chance to prevent blindness The problem? many hospitals have a
shortage of qualified ophthalmologist to monitor babies for ROP. Of the half million or so babies born
prematurely in the US each year only a small fraction need treatment but
all babies born at less than 31 weeks of pregnancy or who weigh less than 3.3 pounds at
birth need monitoring for ROP. Monitoring all those babies takes time. Doctor quinn led a study called eROP
to determine if monitoring could be accomplished by telemedicine. What we were calling it is e-ROP because
we electronically send the images to a central Center where they are graded…not by graders who do not see the baby but they
see the images from the baby. in ROP blood vessels in the tissue
in the back of the eye called the retina begin to grow abnormally which can lead
to scarring and detachment of the retina Treatment involves destroying the
abnormal blood vessels with lasers or freezing them using a technique called
cryoablation The study took place during the usual
care of more than 1200 premature infants at 13
clinical centers. Whenever an ophthalmologist examined one of the babies in the study another staff member used a special
camera to take pictures of the babies’ retinas. Image readers at the University of
Pennsylvania who were trained to identify ROP then judged which infants
they thought had signs of the disease. Investigators then compared the
conclusions made by the image readers to the conclusions made by the
ophthalmologists. We found there was very good likelihood of agreement between the diagnostic
examination by the doctor and gradings from the trained readers. Telemedicine screening for ROP
could have several benefits It can be done more frequently than
screening by an ophthalmologist who may have limited availability. depending on location. Telemedicine may
catch ROP earlier. In the study image readers identified
forty-three percent of advanced ROP cases on average about 15 days earlier
than the ophthalmologists. And telemedicine could bring down the
cost of ROP screening by reducing the demands on
ophthalmologists. whose time has better allocated to
babies who need their attention an expertise. NEI had the foresight to
say it’s a valuable study for us to do and Ellie Schron and the people in the clinical side of NEI were so helpful in making us aware of the
importance of ROP… not that that had to be reinforced a lot… but understanding the importance of it and
really supporting our efforts. just a very positive way

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