Evaluation of retinopathy of prematurity incidence with telemedicine confirmation in Gansu, China: a pilot study

Zhang, Xinxin; Wang, Yuping; Ulrich, J. Niklas; Yang, Yi; Ding, Leona; Xu, Ding; Tarczy-Hornoch, Kristina; Cabrera, Michelle T.

doi:10.1080/09286586.2017.1368671

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…In fact, H-I and subsequent reperfusion generate an increment in reactive species. This increase causes neuronal loss and can ultimately lead to blindness, as it occurs in retinopathy of prematurity (ROP) [ 26 , 27 ]. Exposure to H-I/reperfusion induces the expression of hypoxia inducible factor-1α (Hif1α) and its target genes, e.g., vascular endothelial growth factor (VEGF).…”

Section: Introductionmentioning

confidence: 99%

Nucleoredoxin Plays a Key Role in the Maintenance of Retinal Pigmented Epithelium Differentiation

et al. 2022

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Nucleoredoxin (Nrx) belongs to the Thioredoxin protein family and functions in redox-mediated signal transduction. It contains the dithiol active site motif Cys-Pro-Pro-Cys and interacts and regulates different proteins in distinct cellular pathways. Nrx was shown to be catalytically active in the insulin assay and recent findings indicate that Nrx functions, in fact, as oxidase. Here, we have analyzed Nrx in the mammalian retina exposed to (perinatal) hypoxia-ischemia/reoxygenation, combining ex vivo and in vitro models. Our data show that Nrx regulates cell differentiation, which is important to (i) increase the number of glial cells and (ii) replenish neurons that are lost following the hypoxic insult. Nrx is essential to maintain cell morphology. These regulatory changes are related to VEGF but do not seem to be linked to the Wnt/β-catenin pathway, which is not affected by Nrx knock-down. In conclusion, our results strongly suggest that hypoxia-ischemia could lead to alterations in the organization of the retina, related to changes in RPE cell differentiation. Nrx may play an essential role in the maintenance of the RPE cell differentiation state via the regulation of VEGF release.

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Section: Introductionmentioning

confidence: 99%

Nucleoredoxin Plays a Key Role in the Maintenance of Retinal Pigmented Epithelium Differentiation

et al. 2022

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“…One such solution is telemedicine in ROP care, where images are obtained by paramedics, stored, and shared with a remotely located ophthalmologist for further decision-making. [ 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 ] It is particularly useful in providing timely care to babies in underserved communities with limited resources.…”

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confidence: 99%

Outcome of real-time telescreening for retinopathy of prematurity using videoconferencing in a community setting in Eastern India

Padhi,

Bhunia,

Das

et al. 2024

Indian Journal of Ophthalmology

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Purpose: To evaluate the feasibility and outcome of a real-time retinopathy of prematurity (ROP) telescreening strategy using videoconferencing in a community setting in India. Method: In a prospective study, trained allied ophthalmic personnel obtained the fundus images in the presence of the parents and local childcare providers. Analysis of images and parental counseling were done in real time by an ROP specialist located at a tertiary center using videoconferencing software. A subset of babies was also examined using bedside indirect ophthalmoscopy by an ROP care-trained ophthalmologist. The data were analyzed using descriptive statistics, sensitivity, specificity, positive and negative predictive values, and correlation coefficient. Results: Over 9 months, we examined 576 babies (1152 eyes) in six rural districts of India. The parents accepted the model as they recognized that a remotely located specialist was evaluating all images in real time. The strategy saved the travel time for ROP specialists by 477 h (47.7 working days) and for parents (47,406 h or 1975.25 days), along with the associated travel cost. In a subgroup analysis (100 babies, 200 eyes), the technology had a high sensitivity (97.2%) and negative predictivity value (92.7%). It showed substantial agreement (k = 0.708) with the bedside indirect ophthalmoscopy by ROP specialists with respect to the detection of treatment warranting ROP. Also, the strategy helped train the participants. Conclusion: Real-time ROP telescreening using videoconferencing is sensitive enough to detect treatment warranting ROPs and saves skilled workforce and time. The real-time audiovisual connection allows optimal supervision of imaging, provides excellent training opportunities, and connects ophthalmologists directly with the parents.

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Artificial intelligence for retinopathy of prematurity

Gensure

Chiang

Campbell

2020

Current Opinion in Ophthalmology

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Purpose of review In this article, we review the current state of artificial intelligence applications in retinopathy of prematurity (ROP) and provide insight on challenges as well as strategies for bringing these algorithms to the bedside. Recent findings In the past few years, there has been a dramatic shift from machine learning approaches based on feature extraction to ‘deep’ convolutional neural networks for artificial intelligence applications. Several artificial intelligence for ROP approaches have demonstrated adequate proof-of-concept performance in research studies. The next steps are to determine whether these algorithms are robust to variable clinical and technical parameters in practice. Integration of artificial intelligence into ROP screening and treatment is limited by generalizability of the algorithms to maintain performance on unseen data and integration of artificial intelligence technology into new or existing clinical workflows. Summary Real-world implementation of artificial intelligence for ROP diagnosis will require massive efforts targeted at developing standards for data acquisition, true external validation, and demonstration of feasibility. We must now focus on ethical, technical, clinical, regulatory, and financial considerations to bring this technology to the infant bedside to realize the promise offered by this technology to reduce preventable blindness from ROP.

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Evaluation of retinopathy of prematurity incidence with telemedicine confirmation in Gansu, China: a pilot study

Abstract: Telemedicine may be helpful in confirming ROP incidence and may serve as a training and support model for less experienced and professionally isolated ROP examiners.

Cited by 5 publications

References 15 publications

Nucleoredoxin Plays a Key Role in the Maintenance of Retinal Pigmented Epithelium Differentiation

Nucleoredoxin Plays a Key Role in the Maintenance of Retinal Pigmented Epithelium Differentiation

Outcome of real-time telescreening for retinopathy of prematurity using videoconferencing in a community setting in Eastern India

Artificial intelligence for retinopathy of prematurity

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