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Internet-based versus Conventional Referral System for Retinopathy of Prematurity Screening in Iran
Nazanin Ebrahimiadib1, Ramak Roohipour2, Reza Karkhaneh2
1a Retina Service, Department of Ophthalmology , Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston , MA, USA.
Insights
An internet-based system for retinopathy of prematurity (ROP) screening significantly reduced delayed examinations and advanced ROP cases in premature infants compared to traditional methods.
Area of Science:
- Ophthalmology
- Neonatology
- Health Informatics
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Timely screening and treatment are crucial for preventing severe visual impairment.
- Traditional referral systems can lead to delays in ROP screening.
Purpose of the Study:
- To compare the effectiveness of an internet-based referral system versus a traditional system for ROP screening.
- To evaluate the impact of an online system on the timeliness of ROP examinations.
- To assess the incidence of advanced ROP in infants managed through different referral systems.
Main Methods:
- A prospective observational study comparing two referral systems: internet-based (Group A) and conventional (Group B).
- Premature neonates (gestational age <37 weeks or birth weight <3000g) were included.
- Data on time to first examination and ROP severity were collected and analyzed.
Main Results:
- The internet-based system significantly reduced the time to the first ROP examination for both preterm infants with gestational age ≤27 weeks and those with gestational age >27 weeks.
- Fewer cases of advanced ROP were observed in the internet-based group (0.1%) compared to the conventional group (2.5%).
- All infants registered in the internet-based system attended their first screening examination.
Conclusions:
- An internet-based registration system improves the efficiency of ROP screening by reducing delays in initial examinations.
- This digital approach leads to a significant decrease in the occurrence of advanced retinopathy of prematurity.
- Implementing internet-based systems is a promising strategy for optimizing ROP care in premature infants.
Purpose:
To compare the efficacy of an internet-based versus traditional referral system for retinopathy of prematurity (ROP) screening in Iran.
Methods:
Two referral screening systems were compared in this prospective observational study. Group A (internet-based) comprised premature babies who were registered into an online system for screening. Their appointments were scheduled automatically based on standardized criteria. Group B (conventional) comprised premature babies whose referrals were based on oral or written recommendations. Babies were referred based on standard criteria (gestational age, GA, <37 weeks or birth weight < 3000 g).
Results:
A total of 2115 neonates were screened between October 2011 and October 2012. From these 1896 met the inclusion criteria (group A n = 856, group B n = 1040). Time of first examination for neonates with GA≤27 weeks was 30.07± 2.72 weeks postmenstrual age in group A and 38.52± 7.03 weeks in group B (p = 0.049), and for neonates with GA>27 weeks was 4.86 ±1.77 and 8.16 ±4.93 weeks after birth in groups A and B, respectively (p < 0.001). All registered babies in group A attended their first screening exam. One case (0.1%) of advanced ROP developed in group A (in a patient with poor follow-up compliance), whereas advanced stages of ROP were seen in 26 cases (2.5%) in group B (p < 0.001).
Conclusion:
An internet-based registration system for ROP screening resulted in fewer cases of delayed first examination and resulted in fewer babies with advanced ROP.
