Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): Five Years of Screening With Telemedicine

Fijalkowski, Natalia; Zheng, Luo; Henderson, Michael T.; Wang, Sean K.; Wallenstein, Matthew B.; Leng, Theodore; Moshfeghi, Darius M.

doi:10.3928/23258160-20140122-01

Cited by 77 publications

(40 citation statements)

References 43 publications

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“…4 One strategy now being adopted to reduce the number of ROP examinations is the use of digital retinal imaging with ROP examinations prompted by abnormal findings on image evaluation. 5,6 Previous studies of community-based digital retinal imaging programs 7 and the recently completed multicenter e-ROP (Telemedicine Approaches to Evaluating Acute-Phase ROP) study 8 have found that this approach can be highly accurate even when images are obtained at the bedside and evaluated remotely by trained nonphysician personnel. Although replacing examinations with digital imaging may not decrease the infant's stress associated with ROP evaluations (eg, both approaches often require eye speculums; for digital imaging, the camera is in contact with a gel applied to the eye), digital imaging with remote interpretation may lower overall health care costs.…”

mentioning

confidence: 99%

A Comparison of Strategies for Retinopathy of Prematurity Detection

Kemper

Prosser²,

Wade

et al. 2016

Pediatrics

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mentioning

confidence: 99%

A Comparison of Strategies for Retinopathy of Prematurity Detection

Kemper

Prosser²,

Wade

et al. 2016

Pediatrics

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“…The store-and-forward telemedicine can help improve travel time for ophthalmologists, logistical coordination with other healthcare staff, and accessibility to remote experts [6]. The use of the RetCam (Clarity Medical Systems, Pleasanton, CA, USA), a wide-angle digital fundus camera, in the screening of ROP to identify infants who require further treatment was warranted with 100% sensitivity and 99.8% specificity from a study conducted by the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) telemedicine initiative [7].…”

Section: Brief Communication (Original)mentioning

confidence: 99%

A store-and-forward telemedicine for retinopathy of prematurity screen: is it cost-effective in Thailand?

et al. 2015

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Background: Prompt diagnosis and treatment of retinopathy of prematurity (ROP) is crucial to prevent blindness. Telemedicine for ROP diagnosis can be applied in regions that lack an expert ophthalmologist. Objectives: To assess the value-for-money of telemedicine in screening for ROP in high-risk infants. Methods: A cost-utility analysis of screening and diagnosis of ROP using telemedicine was compared with the current process for ROP screening (Thai Clinical Trials Registry Identification No. TCTR20130911001). We used decision analytical models to compare costs and outcomes in terms of quality-adjusted life years (QALY) to the health provider and society. We used one-way sensitivity analysis and probabilistic sensitivity analysis to consider parameter uncertainty. Results: The total capital cost for telemedicine to the health provider was 951,000 THB per year. With the base case analysis of 400 children screened per year per RetCam, the performance of screening and diagnosis of ROP using telemedicine (100% sensitivity and 97.8% specificity) was higher compared with the current method (88.9% sensitivity and 93.4% specificity). We therefore expect that blindness can be prevented in 3 children per 400 screening cases. The incremental cost to society of telemedicine compared with the current practice was 837 THB. Preventing just one child from becoming blind can save around 146,000 THB throughout their lifetime based on savings to welfare costs for disabled people. The incremental cost-effectiveness ratio of this telemedicine was 259 THB per case of prevented blindness and 17,397 THB per QALY saved. Conclusions: Store and forward telemedicine for ROP screening is cost-effective.

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“…The efficacy of teleretinal screening for ROP using RetCam has been validated in several studies. [27][28][29][35][36][37][38][39][40][41]44 Notably, the Recently, the multicenter Telemedicine Approaches to Evaluating AcutePhase Retinopathy of Prematurity (e-ROP) study created a grading system for digital ROP images, where nonphysicians were successfully trained to grade and screen for patients with referral-warranted ROP. 45 These findings suggest that telemedicine appears to be a safe, reliable, and cost-effective complement to direct examinations by ROP specialists, with the potential to increase screening and extend treatment to infants with vision-threatening disease.…”

Section: Pediatric Retinal Diseasesmentioning

confidence: 99%

Wide-field Imaging of Retinal Diseases

Kim¹,

Moshfeghi²

2015

US Ophthalmic Review

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125Retinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. Since the invention of the direct ophthalmoscope by Hermann von Helmholtz in 1851, techniques to visualize the fundus have grown exponentially both in number and sophistication. Notably, wide-field retinal imaging has taken center stage over the past 2 decades. Given its increasing popularity in research and clinical use, it is important to be aware of the different types of wide-field imaging currently available, as well as the clinical applications for, advantages, and limitations of widefield retinal imaging. This review article aims to highlight our current understanding of wide-field retinal imaging and provide an outlook for its future implications. Historical PerspectiveThe first fundus camera was developed by Frederick Dimmer at the turn of the 20th century. Dimmer was the first to incorporate fundus photography into an ophthalmic textbook, and he published the first photographic atlas in black-and-white. AbstractRetinal imaging serves as a critical adjunct to the diagnosis, monitoring, and treatment of numerous ocular diseases. In particular, wide-field retinal imaging is quickly moving to the forefront in imaging the posterior segment. While conventional fundus imaging captures 30 to 50° field of view in a single capture, significant advances have been made in the past 2 decades to increase the viewing angle, speed, and accuracy of fundus photography, such that a single-field capture is now up to 200°. Moreover, multiple imaging modalities, including color fundus photography, fluorescein angiography, and autofluorescence, are now available a single wide-field imaging platform. This breadth of functionality makes wide-field imaging especially useful in peripheral retinal vascular diseases, such as diabetic retinopathy, posterior uveitis, and retinopathy of prematurity. This review aims to provide a historical perspective on wide-field retinal imaging, highlight the imaging platforms currently available, discuss the advantages and disadvantages of wide-field versus conventional fundus imaging, summarize the current clinical applications of wide-field retinal imaging, and provide an outlook for its future implications. KeywordsWide-field imaging, ultra-wide-field imaging, retinal imaging, Optos, Heidelberg, fluorescein angiography, autofluorescence, diabetic retinopathy, retinal vein occlusion, retinopathy of prematurity Disclosure: Esther Kim, MD, has no relevant conflicts of interest to declare. Andrew A Moshfeghi, MD, MBA, has been a consultant

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Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): Five Years of Screening With Telemedicine

Abstract: Telemedicine demonstrates high diagnostic accuracy for detection of TW-ROP and can complement ROP screening.

Cited by 77 publications

References 43 publications

A Comparison of Strategies for Retinopathy of Prematurity Detection

A Comparison of Strategies for Retinopathy of Prematurity Detection

A store-and-forward telemedicine for retinopathy of prematurity screen: is it cost-effective in Thailand?

Wide-field Imaging of Retinal Diseases

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