Screening and treatments using telemedicine in retinopathy of prematurity

Abstract

Several studies have validated the role of telemedicine as a new powerful screening and diagnostic tool for retinal disorders, such as diabetic retinopathy and retinopathy of prematurity. With regard to retinopathy of prematurity, bedside examination with binocular indirect ophthalmoscopy has been the gold standard technique for screening, yet with several limitations. Herein, we review the current evidence that supports the role of telemedicine for the screening of infants with retinopathy of prematurity.

Keywords: retinopathy of prematurity; screening; telemedicine.

Figure 1

Computer screenshot of the interface of a telemedicine software. Notes: A standard set of six photos is captured (external photo, posterior pole centered around the nerve, temporal, nasal, inferior, and superior). The software is capable of generating a montage of the acquired images. Abbreviations: PMA, post-menstrual age; Cest, gestational age; SUP, superior; EXT, external; TEMP, temporal; POST, posterior pole; NAS, nasal; INF, inferior; Indet, indeterminate; S1, Stage 1; S2, Stage 2; S3 Flat, Stage 3 with flat neovascularization; S4/S5, Stage 4/Stage5.

Figure 2

Computerized Zone 1 determination. Notes: (A) Computerized software determination of Zone 1 in retinopathy of prematurity (ROP) (yellow circle). Notice the image processing capabilities (change brightness, contrast, and color saturation), which can aid in the modification of the original photo to allow a more accurate review. (B) Fundus image of the left eye of an infant with a heavily pigmented fundus obtained with a wide-field contact fundus camera (RetCam; Clarity Medical Systems, Pleasanton, CA, USA) and type 1 ROP requiring laser treatment. Media opacity is due to vitreous hemorrhage, which renders the retinal vessels difficult to discern.