DEC 01, 2008
Comprehensive Ophthalmology, Pediatric Ophth/Strabismus, Retina/Vitreous
This retrospective study presents the one-year results of the Stanford University Network Retinopathy of Prematurity (SUNDROP) telemedicine initiative. Trained nurses screened the infants with the RetCam II, and a single ophthalmologist skilled in diagnosing ROP evaluated the images. Of the 42 infants screened no child who needed a referral was missed (sensitivity was calculated at 100 percent, specificity 95 percent). No patient progressed to retinal detachment.
To those uncomfortable with the transition away from an ophthalmologist evaluating a patient at their bedside, the authors note that telemedicine has surpassed the safety standards of ROP screening in previous studies comparing it with a bedside examination "and has proven entirely safe in this trial of its use as a sole ROP screening tool. Furthermore, telemedicine in this report is not being used to diagnose ROP requiring treatment, only to identify cases suspicious for ROP requiring treatment with confirmation still performed by the gold-standard bedside examination by a trained professional."
In addition, they write that other disciplines have applied telemedicine strategies in the management of their patients following less impressive reports of its sensitivity in those medical circumstances.
"Such disciplines include cardiology (deeming 87-94% sensitivity and a negative predictive value of 75% as safe in the detection of pediatric heart disease) and even the evaluation of diabetic retinopathy which now utilises stereoscopic images as the standard for its detection and evaluation by trained readers."