Telemedicine

Telemedicine

 

The advent of telemedicine offers the opportunity

for improved ROP screening in remote

areas and thus has the potential to reduce the

risk of avoidable severe visual impairment [34,

45]. In our prospective study, the RetCam120 has

been used for ROP screening in five Bavarian

NICUs since 2001. To date, in 2005, more than

600 infants at risk have been examined. Four of

these NICUs are peripheral sites, with ROP

screening performed by general ophthalmologists.

            All images are transferred to the Reading

Center at the University of Regensburg for evaluation.

The objective of this screening program

is targeted at detection of the need for a specialist

consult to make the final treatment decision

in the presence of referral-warranted ROP and

thereby ideally eliminate late referrals.Thus, the

sensitivity to detection of inconsequential disease

is not at issue. In this program, digital imaging

using the RetCam 120 was successful in

detecting all referral-warranted ROP stages,

with no incidents where treatment-requiring

disease was missed of referred late, and with no

false-negative or false-positive results in a subset

of patients where digital imaging and BIO

were directly compared, i.e., the sensitivity and

the specificity to detect referral-warranted ROP

were both 100 % .

 

Prerequisites for effective prevention of severe

visual handicap in premature children are adequate

screening and correct interpretation of

the findings. National evidence-based guidelines

have been developed from multicenter

studies. Because of increasing knowledge with

the natural course of the disease and the

anatomical and functional outcome with actual

treatment regimes, new treatment recommendations

have recently evolved that eventually

may modify actual guidelines. Because of late

sequelae such as ametropia, amblyopia, strabismus,

secondary glaucoma, and secondary retinal

detachment, life-long ophthalmological examinations

are mandatory.

 

 

 

 

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