Using telemedicine to screen for retinopathy of prematurity

Aziz, Ahmed Abdel; Isaac, Maram; Tehrani, Nasrin

doi:10.1503/cmaj.131357

Cited by 12 publications

(11 citation statements)

References 10 publications

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“…The Ontario Telemedicine for Retinopathy of Prematurity (ONTROP) has developed a program that has paired digital retinal imaging with a 2-way audio-video connection for ROP screening. 1 A cost analysis of ONTROP by Isaac et al 9 further supports this initiative given the lower average total cost per eye exam of infants in the telemedicine group compared to control. This calls for continuing exploration of wide-field retinal imaging as a part of teleophthalmology initiatives around the country in order to provide safe, efficient ROP screening that is reasonably accessible to infants in remote communities.…”

Section: What’s Next?mentioning

confidence: 93%

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Screening for Retinopathy of Prematurity Through Utilization a Pediatric Retinal Camera at Jim Pattison Children’s Hospital: A Vision for Improved Care

Karunatilake

Daspal

Samedi

et al. 2021

Global Pediatric Health

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Section: What’s Next?mentioning

confidence: 93%

“…The transfer of at-risk infants from level III NICUs to remote ones are often delayed for their eye exam to occur—this has been associated to increased health care costs, visual morbidity, and inconvenience for families. 1 …”

Section: What’s Next?mentioning

confidence: 99%

Screening for Retinopathy of Prematurity Through Utilization a Pediatric Retinal Camera at Jim Pattison Children’s Hospital: A Vision for Improved Care

Karunatilake

Daspal

Samedi

et al. 2021

Global Pediatric Health

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“…All around the world, several other telemedicine experiments have been described in countries where either the long distances or the lack of trained specialists is a severe limitation to compliance with ROP screening guidelines [ 12 , 13 ]. These are not necessarily developing countries but for example USA [ 14 ], Canada [ 15 ], Australia [ 16 ], Chile [ 17 ] and India [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in this study, we addressed the value of tele-expertise from a public health perspective. The objective was not to assess effectiveness of such a program to detect and treat ROP, which has been largely reviewed [ 13 , 19 – 21 ], but whether its implementation enabled an improvement in access to care in medical centers with limited medical resources. We therefore did not collect data on examination results or treatments.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and efficiency of tele-expertise for improving access to retinopathy screening among 351 neonates in a secondary care center: An observational, controlled before-after study

et al. 2018

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In France, secondary care hospitals encounter difficulties to adhere to retinopathy of prematurity (ROP) screening guidelines. Our objective was to assess the effectiveness and efficacy of a tele-expertise program for ROP screening in neonatal intensive care units without on-site ophthalmologists. We evaluated the impact of a tele-expertise program funded by the Paris Region Health Authority in a secondary care center general hospital of the Paris Region (CHSF), where there was previously no on-site ophthalmologist. We performed an observational, controlled before-after study, with a university tertiary care center with on-site ophthalmologists (Port-Royal) as the control group. Recruitment and data collection for both periods took place from 1 January 2012 to 31 December 31 2012, and from 1 January 2014 to 31 March 2015. The primary endpoint was the percentage of compliance with screening guidelines, secondary endpoints included pain scores and costs. Over the two periods, at total of 351 infants were recruited in the CHSF. Implementation of the tele-expertise resulted in an absolute +57.3% increase in the proportion of examinations realized in accordance with guidelines (3.8% during the "before" period and 61.1% during the "after" period, p<0.001). As compared with the control group, the proportion of infants appropriately screened improved (57.5% versus 43.1%, p = 0.002); median pain score on the acute pain rating scale for neonates during examination was significantly higher (median score 5.5/10, range [2.5–5.7] versus 2.0/10, range [1.0–3.1], p = 0.002). Screening rates in the control group remained unchanged. The average cost per examination increased from €337 in the "before" period to €353 in the "after period" in the tele-expertise group. The implementation of tele-expertise for ROP screening in the CHSF medical center resulted in a major improvement of access to care with a small cost increase. The issue of pain control during examination with tele-expertise should be further addressed.

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“…Novel imaging devices in combination with AI technology, as seen with the work by the Imaging and Informatics in Retinopathy of Prematurity (i-ROP) Research Consortium, could facilitate cost-effective telemedicine-based ROP screening in low-resource settings. The need for exacting protocols on image acquisition and image interpretation has been highlighted by many experts as a key priority ( Abdul Aziz, Isaac, and Tehrani 2014 ).…”

Section: Digital Innovations For Eye Diseasesmentioning

confidence: 99%

Digital technology, tele-medicine and artificial intelligence in ophthalmology: A global perspective

Liu

Ting

et al. 2021

Progress in Retinal and Eye Research

364

273

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The simultaneous maturation of multiple digital and telecommunications technologies in 2020 has created an unprecedented opportunity for ophthalmology to adapt to new models of care using tele-health supported by digital innovations. These digital innovations include artificial intelligence (AI), 5th generation (5G) telecommunication networks and the Internet of Things (IoT), creating an inter-dependent ecosystem offering opportunities to develop new models of eye care addressing the challenges of COVID-19 and beyond. Ophthalmology has thrived in some of these areas partly due to its many image-based investigations. Tele-health and AI provide synchronous solutions to challenges facing ophthalmologists and healthcare providers worldwide. This article reviews how countries across the world have utilised these digital innovations to tackle diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, glaucoma, refractive error correction, cataract and other anterior segment disorders. The review summarises the digital strategies that countries are developing and discusses technologies that may increasingly enter the clinical workflow and processes of ophthalmologists. Furthermore as countries around the world have initiated a series of escalating containment and mitigation measures during the COVID-19 pandemic, the delivery of eye care services globally has been significantly impacted. As ophthalmic services adapt and form a “new normal”, the rapid adoption of some of telehealth and digital innovation during the pandemic is also discussed. Finally, challenges for validation and clinical implementation are considered, as well as recommendations on future directions.

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Using telemedicine to screen for retinopathy of prematurity

Cited by 12 publications

References 10 publications

Screening for Retinopathy of Prematurity Through Utilization a Pediatric Retinal Camera at Jim Pattison Children’s Hospital: A Vision for Improved Care

Screening for Retinopathy of Prematurity Through Utilization a Pediatric Retinal Camera at Jim Pattison Children’s Hospital: A Vision for Improved Care

Effectiveness and efficiency of tele-expertise for improving access to retinopathy screening among 351 neonates in a secondary care center: An observational, controlled before-after study

Digital technology, tele-medicine and artificial intelligence in ophthalmology: A global perspective

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