Telemedicine detection of type 1 ROP in a distant neonatal intensive care unit

PURPOSE To demonstrate the feasibility of telemedicine screening for retinopathy of prematurity (ROP) by summarizing the results of our experience screening premature infants at a distant hospital in a rural location. METHODS Records of all premature infants remotely screened for ROP at a neonatal intensive care unit in Great Falls, Montana, from January 1, 2007 to June 30, 2011, were retrospectively reviewed. The RetCam II imaging system was used to capture retinal images, which were posted on a secure server for evaluation by one of two pediatric ophthalmologists. Infants suspected of having ROP approaching the criteria for laser treatment were transferred to a hospital, where a diagnostic examination was performed and treatment administered when indicated. All other infants received an outpatient diagnostic examination within 2 weeks of discharge. RESULTS A total of 582 telemedicine examinations were performed on 137 infants during the study period. Of 13 infants transferred for referral-warranted ROP, 9 ultimately required laser treatment. Good outcomes were noted in all cases, with none progressing to stage 4 or 5 ROP. CONCLUSIONS Telemedicine ROP screening detected patients at a remote site in need of laser treatment, allowing prompt transfer with no poor outcomes over a 4.5-year period. Our experience demonstrates the utility of remote screening for ROP. (J AAPOS 2012;16:229-233)