Document Detail


Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): 18-month experience with telemedicine screening.
MedLine Citation:
PMID:  18784936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report the 18-month experience of the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) telemedicine initiative. DESIGN: Retrospective analysis of the SUNDROP archival data between 1 December 2005 and 30 May 2007, evaluating this new diagnostic technology for ROP screening. PARTICIPANTS: All 97 consecutively enrolled infants in the SUNDROP network. METHODS: All patients were screened using the RetCam II, and evaluated by the SUNDROP reading center at Stanford University. Nurses were trained to obtain five images in each eye. All patients were screened by an ophthalmologist trained in diagnosing ROP within 1 week of discharge from the hospital. MAIN OUTCOME MEASURES: Outcomes included referral-warranted disease, need for treatment, and anatomic outcomes. Referral-warranted disease was defined as any Early Treatment Retinopathy of Prematurity Disease Type 2 or greater, threshold disease, any plus disease, and any stage 4 or higher disease. RESULTS: In the initial 18-month period, the SUNDROP telemedicine screening initiative has not missed any referral-warranted disease for ROP. A total of 97 infants (194 eyes) were enrolled, resulting in 443 unique examinations and 4,929 unique images. The mean birth weight of the infants was 1,186.9 grams, with a mean gestational age at birth of 28.9 weeks. Seven infants were identified with referral-warranted disease; six patients underwent laser photocoagulation and completely regressed. The one remaining patient regressed spontaneously, and did not require intervention. Calculated sensitivity and specificity was 100% and 98.9% respectively. No patient progressed to retinal detachment or other adverse outcome. Inadequate exposure, artifact, poor visualization of the periphery, and lack of a complete standardized image set in some patients were identified as areas requiring further assessment. CONCLUSIONS: The SUNDROP telemedicine screening initiative for ROP has proven to have a high degree of sensitivity and specificity for identification of referral-warranted disease. Training was easily implemented. All cases of referral-warranted disease were captured. There were no adverse outcomes.
Authors:
Ruwan A Silva; Yohko Murakami; Atul Jain; Jarel Gandhi; Eleonora M Lad; Darius M Moshfeghi
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Publication Detail:
Type:  Journal Article; Validation Studies     Date:  2008-09-11
Journal Detail:
Title:  Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie     Volume:  247     ISSN:  1435-702X     ISO Abbreviation:  Graefes Arch. Clin. Exp. Ophthalmol.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-04-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8205248     Medline TA:  Graefes Arch Clin Exp Ophthalmol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  129-36     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Diagnostic Techniques, Ophthalmological / standards*
Female
Humans
Infant, Newborn
Infant, Premature
Male
Neonatal Nursing / methods*
Neonatal Screening / methods,  standards*
Referral and Consultation
Retinopathy of Prematurity / diagnosis*,  nursing*
Retrospective Studies
Sensitivity and Specificity
Telemedicine / standards*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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