Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): 18-month experience with telemedicine screening

Abstract

The SUNDROP telemedicine screening initiative for ROP has proven to have a high degree of sensitivity and specificity for identification of referral-warranted disease. Training was easily implemented. All cases of referral-warranted disease were captured. There were no adverse outcomes.

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

“…12,[18][19][20][21][22] At each site, a team of 1 or 2 nurses was responsible for positioning the infant, monitoring vital signs, and performing digital imaging. Infants were dilated with 2.5% phenylephrine and 1% tropicamide 30 to 60 minutes before imaging, with feedings discontinued 2 hours before and after examination in accordance with aspiration precaution guidelines.…”

Parental perceptions toward digital imaging and telemedicine for retinopathy of prematurity management

“…From a medical perspective, retinal imaging may become important, because published studies have demonstrated that the accuracy and consistency of plus disease diagnosis are imperfect, even when performed by recognized experts [27,28]. Previous studies have demonstrated that agreement between ophthalmoscopic and telemedical ROP examination modalities is high, even when images are captured by a trained neonatal nurse, and that telemedicine may actually be more accurate in some cases [9][10][11][12][13][14][15][16][17]. Therefore, from a medicolegal perspective, imaging may become important as a mechanism for objective documentation of examination findings.…”

“…This has potential to address many of the existing limitations of ROP care, and has become more realistic with the increasing availability of wide-angle digital retinal imaging devices. Using these cameras, telemedicine has been shown to have high accuracy and reliability for ROP diagnosis [9][10][11][12][13][14][15][16][17], and to be possibly more cost-effective than standard ophthalmoscopy for disease management [18,19]. However, no previous research to our knowledge has formally examined the acceptability of telemedicine to infants' families.…”

Telemedicine for Evaluation of Retinopathy of Prematurity

“…4 A number of reports have addressed various aspects of this issue. [5][6][7][8][9][10][11] However, the pace of implementation of RDFI with TM for ROP evaluation in the ophthalmic community has outstripped the pace of systematic evaluation of the approach. A consensus "standard of care " has not yet been established.…”