Telemedicine can accurately diagnose rare cause of preemie blindness

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Telemedicine has been shown to accurately diagnosis a rare cause of blindness in premature babies as effectively overall as in-person eye exams.

Researchers from Oregon Health & Science University teamed with seven medical institutions to examine the eyes of 281 infants who were at risk for retinopathy of prematurity (ROP), a rare but devastating cause of blindness in preemies.

They compared the accuracy of in-person exams with digital eye images that were remotely evaluated using telemedicine and found that there was no difference in the overall accuracy between the two evaluation methods. Results of the study were published in the journal JAMA Ophthalmology.

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While in-person examiners were found to be slightly better at accurately diagnosing ROP’s later-stage development, researchers concluded that telemedicine could be used to diagnose clinically significant cases of the condition.

“No difference was found in overall accuracy between ophthalmoscopy and telemedicine for the detection of clinically significant ROP, although, on average, ophthalmoscopy had slightly higher accuracy for the diagnosis of zone III and stage 3 ROP,” state the authors. “With the caveat that there was variable accuracy between examiners using both modalities, these results support the use of telemedicine for the diagnosis of clinically significant ROP.”

According to Peter Campbell, MD, a co-author of the study and a pediatric retinal specialist at OHSU, there is a shortage of trained ophthalmologists with experience diagnosing ROP, especially in rural parts of the United States and developing countries.

“Telemedicine has become a solution to that problem,” says Campbell. “Historically, that was always considered inferior to the so-called gold standard of an actual physician examining babies at the bedside.”

However, he contends that this is the first study to directly compare telemedicine to in-person exams, which involve a special magnifying device that shines light into a baby’s dilated eye to diagnose ROP.

“This paper speaks to the idea that telemedicine is safe for delivering care for babies, and with appropriate follow-up, it’s reasonable to implement more of these systems without feeling like you’re providing an inferior standard of care,” concludes Campbell.

The study was organized through the OHSU-led Imaging and Informatics in Retinopathy of Prematurity Research Consortium, which is supported by the National Institutes of Health.

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