EPOS

European Paediatric Ophthalmological Society

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13 Telemedicine in acute ROP. A multicenter study using a digital retinal imaging system

Lorenz, B., Elflein, H., Preising, M.N.

Dept. of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, University of Regensburg, Germany

Purpose: To evaluate the potential of the RetCam 120 in detecting acute retinopathy of prematurity in a remote setting. Methods: RetCams were installed in five NICUs in Eastern Bavaria by February 2001 and all premature infants at risk have been examined with the Retcam since then. The project has been approved by the Ethical Committee of the University, and informed consent was given at each instance. In the 4 NICUs outside Regensburg, the screening was performed by the local ophthalmologists. The images were sent to the Reading Centre at the Dept. of Paediatric Ophthalmology, Strabismology and Ophthalmogenetics, Regensburg. All images were analysed independently by two ophthalmologists to evaluate sensitivity and specificity in comparison to indirect ophthalmoscopy. Results: By July 31st, 110 children have been examined, 4 needed treatment. Handling of the camera was easy, most initial problems were transitory. Pupillary dilation was critical, and the retina peripheral to the equator was imaged only with low contrast. No zone I or zone II disease, and in particular no threshold disease was missed. Estimation of extraretinal proliferations required some experience. Maximal pupillary dilation and some exercise in handling the camera visualised also zone III . Cooperation with the medical staff in the NICU's and the general ophthalmologists was generally good, and the project found the approval of the children's parents. Conclusion: The Retcam 120 combined with telemedicine appears to have the potential to detect all acute ROP that may need treatment, and to overcome examiner dependent differences in expertise.