The safety and feasibility of the screening for retinopathy of prematurity assisted by telemedicine network during COVID-19 pandemic in Wuhan, China

Abstract

Background During the coronavirus disease 2019 (COVID-19) epidemic, due to the traffic blockade and the shortage of medical resources, more and more premature infants could not receive timely and effective ROP screening, which delayed treatment and even caused children blindness. Therefore, how to carry out ROP screening safely and effectively during the epidemic was very important and urgent. This study aimed to evaluate the safety and feasibility of ROP screening assisted by telemedicine network during COVID-19 outbreak. Methods This retrospective study was conducted at Wuhan Children’s hospital in Wuhan, China, from January to October, 2020. The measures which were performed to make the ROP screening more safe and effective were summarized and the comparison between ROP screening assisted by telemedicine network in 2020 and usual screening in 2019 were analyzed. Results A total of 267 outpatient infants completed ROP screening. The median gestational age was 32 weeks (30w to 34w) and the median birth weight was 1780 g (1460 g to 2100 g). Meanwhile, 149 (55.8%) out of 267 infants were males. During January to May in 2020, 86 screening appointments were received, among which 67 (77.9%) were from telemedicine platform online. The completing percentage of total online ROP appointments was higher than that of total face-to-face appointments (58.1% VS 22. 1%, P = 0.018). As for the number of infants screened between 2020 and 2019 from Februaryto October, 54 infants completed ROP screening in 2020, which was higher than that (51participants) in 2019 on September. Furthermore, compared with the usual screening in 2019, ROP screening assisted by telemedicine network in 2020 had smaller gestational age (32w VS 33w, p<0.001) and lower birth weight (1780 g VS 1900 g, p = 0.001). However, of the 267 infants screened, 18(6.7%) had ROP while the percentage of ROP screened in 2019 was the same (44[6.7%]). During follow-up, none of medical staffs was infected and no adverse reaction was reported. Conclusions The screening for retinopathy of prematurity assisted by telemedicine network was safe and feasible during the COVID-19 pandemic. Preventive measures before and after screening were very necessary, which could effectively avoid cross infection.

Nonpharmacological Applications During the Retinopathy of Prematurity Examination and Their Effects on Pain Control

“…[1][2][3] Moreover, ROP is one of the severe pediatric diseases, accounting for 6% to 18% cases of childhood blindness worldwide. 4 The frequency of ROP may vary according to the socioeconomic status of countries and the quality of newborn care. In a previous study, the incidence of ROP in premature infants with birth weight of 1500 g or below was approximately 60%, and the rate of progression to severe ROP (stages 3-5) was approximately 15%, as also confirmed by several other studies.…”

“…ROP is characterized as an eye disease affecting premature infants, and it is one of the leading causes of preventable vision loss and blindness in childhood 1–3. Moreover, ROP is one of the severe pediatric diseases, accounting for 6% to 18% cases of childhood blindness worldwide 4. The frequency of ROP may vary according to the socioeconomic status of countries and the quality of newborn care.…”

Pattern of ocular morbidities during COVID-19 pandemic in a tertiary eye care centre in central India

“…12 Due to the COVID-19 pandemic, the number of babies screened and diagnosed for ROP drastically reduced in India, which can be attributed to a severe presentation of ROP. 13 To avoid blindness in these infants telemedicine network can be used for ROP screening during the COVID-19 pandemic which would be safe, effective, and feasible as supported by Zheng Guo et al in their study. 14 A sudden fall in the number of cases with routine problems was noted because of lack of public transportation, ignorance among the population, fear of contracting the COVID-19 infection, and several restrictions and protocols in hospitals during the nationwide lockdown contributed to the increased burden of the severe form of diseases.…”

Effect of COVID-19 Lockdowns on Eye Emergency Department, Increasing Prevalence of Uveitis and Optic Neuritis in the COVID-19 Era

“…Indeed, elective procedures are the mainstay of ophthalmology, nevertheless delayed treatment of trauma, infection, and retinal or neuro-ophthalmic disorders is responsible for a significant percentage of vision-related disability [ 10 ]. Some of them might be successfully diagnosed and safely monitored via telemedicine methods as a substitute to direct ophthalmic care [ 11 , 12 ]. Prior to COVID-19 pandemic retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration were the mainstay of remotely controlled disorders in ophthalmology [ 13 , 14 , 15 ].…”

“…However, both the range of telemedicine tools (programs, devices) and the number of centers and doctors engaged in tele-visits, contributed to its development and providing care to patients with a broader spectrum of ocular disorders [ 16 , 17 , 18 ]. Nevertheless, some of the ocular disorders might not be properly diagnosed virtually, retina and choroid inflammations being the typical examples [ 12 , 17 , 19 ]. Additionally, considering an increasing number of reports on the autoimmune background of various post-Covid syndromes, it might be of special interest to investigate patterns of emergency eye consultations related to optic neuritis and uveitis [ 20 , 21 ].…”