A national telemedicine network for retinopathy of prematurity screening

PURPOSE To report the results of retinopathy of prematurity (ROP) screening by a telemedicine system in Chile and evaluate its usefulness for referring patients who require treatment. METHODS Premature infants at risk of developing ROP from 11 neonatal intensive care units were included. Screening was performed on all infants born at a gestational age of <32 weeks and/or birth weight of <1500 g. A trained nonphysician operator used an imaging system to capture retinal images, which were reviewed by two independent ROP experts. All infants that required treatment were referred for further evaluation. RESULTS The study included 2,048 eyes of 1,024 premature infants. Mean gestational age was 28.8 +/- 2.2 weeks, and mean birth weight was 1128 +/- 279 g. A total of 5,263 telemedicine examinations were performed and reported. The average number of image sets per patient was 2.6 +/- 2.5. Of the 5,263 images, 4,903 (93%) were recorded to at least the end of zone II; 5,172 (98%) were graded as having good quality, allowing for staging of ROP disease. Forty-two infants (4%) were referred for treatment. Discharged patients with ROP type 2 that regressed did not present with any complications or adverse effects during 6 months' follow-up. CONCLUSIONS Our study demonstrates the utility of telemedicine screening for ROP with ophthalmologist readers in a developing country. Telemedicine screening was able to detect treatment requiring ROP. Most of the images had good quality and showed the end of zone II, two variables sufficient to discharge patients.