Can virtual screening for retinopathy of prematurity work in rural areas?

In rural and areas with limited resources, images with a noncontact fundus camera can be used to help detect treatable retinopathy of prematurity (ROP), according to a study.

Screening criteria included gestational age <36 weeks and/or birth weight (BW) <2000 g, or GA <36 weeks but BW ≥2000 g, with qualifying medical history. Retinal images we obtained by 2 technicians and graded by ophthalmologists experienced in ROP. The screening was stopped when retinal vessels in anterior zone II were normal on 2 successive evaluations or at 45 weeks postmenstrual.

Overall, 418 babies, with a mean GA of 33.9 ± 2.2 weeks (range, 27-36, and mean BW of 1728.3 ± 379.3 g (range, 840-2830 g), were screened. Signs of pre-plus or plus disease were noted in 8.6% of patients, of which 58% underwent an ophthalmologic examination.

Type 1 ROP was confirmed in 15 patients and 14 patients underwent training. Treated infants had a mean GA of 33.6 ± 3.0 weeks (range, 32-34.9) and a mean BW of 1,646 ± 245.8 g (range, 1100-1774.1 g).

Reference
Asturias AL, Gilbert C, Silva Jc JC, et al. Implementation of telemedicine screening for retinopathy of prematurity in rural areas in Guatemala. J AAPOS. 2021;S1091-8531(21)00649-2. doi: 10.1016/j.jaapos.2021.08.307. Epub ahead of print. PMID: 34973448.