Retinopathy of Prematurity (ROP) occurs when abnormal blood vessels in the eye grow over the retina; this disorder could eventually lead to blindness in premature babies. This eye disease causes major concern as more babies are surviving due to advances in neonatal care. The problem is that there are not enough ophthalmologists to provide sufficient care to these patients. One recent survey in Pediatrics shows that only 56 percent of directors from nearly 400 hospital neonatal intensive care units believe there are a sufficient number of ophthalmologists that can screen and/or treat ROP in their local area. Of those surveyed, 28 percent of respondents said their NICU did not provide care for ROP, the most common reason for this was the hospital not having enough ophthalmologists on staff to accommodate Retinopathy of Prematurity. As a result of this many babies who were found to have ROP at birth had to be transferred to other local hospitals that can accommodate ROP treatment.
This is where telemedicine comes into the picture. Experts say telemedicine screening programs can help bridge the gap in treating babies with ROP. “The research came from our own experience of having babies sent to our children’s hospital to stay for weeks and weeks while we watched their eyes,” says lead study author Rebecca Vartanian, M.D., a neonatologist at the University of Michigan C.S. Mott Children’s Hospital. “While increasing the number of well-trained ophthalmologists willing to screen and care for ROP would be ideal, there’s an opportunity to build programs that permit remote screening of babies and identifying those who can stay in their communities,” she says. Help from a distance
Available imaging technology makes it possible to accurately screen for signs of severe ROP by sending images of a baby’s eyes to an image reading center for evaluation. “Before starting this program, babies born in the Marquette area were transferred to Ann Arbor for care and often stayed with us for several weeks for repeated screenings,” says study co-author Cagri G. Besirli, M.D., Ph.D., a pediatric retina specialist. Sponsored by the National Eye Institute, the 2014 study found the telemedicine approach was about as accurate as regular examinations by an ophthalmologist.
“There is a gap to fill in caring for these babies and using telemedicine to bridge this gap is the best option,” says Besirli.