The introduction of digital imaging for retinopathy of prematurity screening is independently associated to higher disease detection: a real-life study

Abstract

Purpose: To evaluate whether retinopathy of prematurity (ROP) diagnosis was modified after the introduction of wide-field imaging for ROP screening compared to previously used binocular indirect ophthalmoscopy (BIO) in real-life conditions. Methods: Records of consecutive premature newborns screened for ROP in a level-3 reference center, over two 1-year periods, were retrospectively reviewed. Screening was performed by ophthalmologists using BIO in 2014, and digital wide-field retinal imaging (PanocamTM pro) in 2019. Systemic factors potentially influencing the occurrence of ROP were investigated using uni- and multivariable linear regression followed by stepwise forward regression. Results: Records of N=297 patients were analyzed (N=159 in 2014 and N=138 in 2019). The proportion of ROP diagnosed at any stage, over the total number of neonates screened, was significantly higher in 2019 (n=46/138, 33.1%) compared to 2014 (n=11/159, 6.9%) (p<0.0001). Most neonates presented with mild forms of ROP during both 1-year periods analyzed. After adjustment for all parameters influencing ROP occurrence, the variables contributing independently to the diagnosis of any stage of ROP were birth weight (p=0.002), duration of mechanical ventilation (p=0.028) and wide-field fundus camera assisted screening (p<0.001). Conclusions: After adjusting for many recognized systemic factors influencing the development of ROP, screening by wide-field digital retinal imaging was independently associated to higher ROP detection.