Auckland regional telemedicine retinopathy of prematurity screening network: A 10-year review

Abstract

Importance: Retinopathy of prematurity (ROP) is a potentially blinding condition affecting the retinae of premature infants. Effective screening is necessary for timely treatment. Background: The Auckland Regional Telemedicine ROP (ART-ROP) network, utilizes wide-field digital imaging for ROP screening. This study reviews the ART-ROP network. Design: Retrospective analysis of the ART-ROP database. Participants: Files of infants in ART-ROP from 2006 to 2015. Methods: Data on infant demographics, ROP stage, treatment and outcome was collected. Main Outcome Measures: The efficacy of ART-ROP in the management of ROP. Results: A review of 1181 infants across three neonatal intensive care units, was completed. Infants had a mean of four screening sessions with no infants who met ROP screening criteria being missed. Type 1 ROP was present in 83 infants, who had significantly lower average birth weight 786 ± 191 g compared to 1077 ± 285 g (P <.001), and gestational age 25.3 ± 1.7 weeks compared to 27.8 ± 2.2 weeks (P <.001) than the screened cohort. The number of infants requiring screening increased (R2 =.7993), yet treatment rates decreased (R2 =.9205) across the time period. Out-patient clinic follow-up was attended by 75.10% of infants screened and there was no missed ROP in those infants seen. Conclusions and Relevance: ART-ROP solely uses wide-field digital imaging for ROP diagnosis, and management, including discharge, of infants. This detailed review of ART-ROP indicates an increase in screening demand, but a decrease in the rate of type 1 ROP. The ART-ROP telemedicine model demonstrates real potential to address workforce shortage in ROP screening.L20024696502019-08-22 <br />2020-01-03 <br />