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Telemedicine retinopathy of prematurity severity score (TeleROP-SS) versus modified activity score (mROP-ActS)
Christine L Xu1, Joel Adu-Brimpong1, Henry P Moshfeghi2
1Department of Ophthalmology, Horngren Family Vitreoretinal Center, Byers Eye Institute, Stanford University School of Medicine, 2452 Watson Ct., Rm 2277, Palo Alto, CA, 94303, USA.
Insights
A new Telemedicine ROP Severity Score (TeleROP-SS) effectively identifies retinopathy of prematurity (ROP) on photographic exams. This score aids in gauging disease severity and tracking treatment response in infants, outperforming existing methods.
Area of Science:
- Ophthalmology
- Neonatal Care
- Medical Imaging
Background:
- Telemedicine is crucial for retinopathy of prematurity (ROP) management in infants.
- Existing grading systems like the modified ROP Activity Scale (mROP-ActS) have limitations for photographic telemedicine exams.
- A need exists for a ROP scoring system optimized for telemedicine, assessing disease progression and treatment needs.
Purpose of the Study:
- To introduce and validate the Telemedicine ROP Severity Score (TeleROP-SS) for ROP assessment via photographic telemedicine.
- To compare the performance of TeleROP-SS against the mROP-ActS in a large cohort of infant eye exams.
- To evaluate the utility of TeleROP-SS in identifying treatment-warranted ROP (TW-ROP) and monitoring disease changes.
Main Methods:
- Retrospective analysis of 1568 telemedicine eye exams from the SUNDROP cohort.
- Development and application of the TeleROP-SS system.
- Comparison of TeleROP-SS and mROP-ActS scoring rates and accuracy for TW-ROP.
Main Results:
- TeleROP-SS achieved a score in 100% of exams, compared to 80.8% (right eyes) and 81.1% (left eyes) for mROP-ActS.
- For TW-ROP, TeleROP-SS scored 100% (right) and 95% (left) of cases, significantly higher than mROP-ActS (70% right, 63% left).
- TeleROP-SS demonstrated ability to track disease improvement or deterioration on telemedicine evaluations.
Conclusions:
- The TeleROP-SS is a robust and comprehensive scoring system for ROP identification and management using telemedicine.
- TeleROP-SS offers superior performance over mROP-ActS for photographic telemedicine, especially for treatment-warranted cases.
- This adaptable score facilitates timely treatment decisions and monitoring of ROP progression in at-risk infants.
Abstract:
Identifying and planning treatment for retinopathy of prematurity (ROP) using telemedicine is becoming increasingly ubiquitous, necessitating a grading system to help caretakers of at-risk infants gauge disease severity. The modified ROP Activity Scale (mROP-ActS) factors zone, stage, and plus disease into its scoring system, addressing the need for assessing ROP's totality of binocular burden via indirect ophthalmoscopy. However, there is an unmet need for an alternative score which could facilitate ROP identification and gauge disease improvement or deterioration specifically on photographic telemedicine exams. Here, we propose such a system (Telemedicine ROP Severity Score [TeleROP-SS]), which we have compared against the mROP-ActS. In our statistical analysis of 1568 exams, we saw that TeleROP-SS was able to return a score in all instances based on the gradings available from the retrospective SUNDROP cohort, while mROP-ActS obtained a score of 80.8% in right eyes and 81.1% in left eyes. For treatment-warranted ROP (TW-ROP), TeleROP-SS obtained a score of 100% and 95% in the right and left eyes respectively, while mROP-ActS obtained a score of 70% and 63% respectively. The TeleROP-SS score can identify disease improvement or deterioration on telemedicine exams, distinguish timepoints at which treatments can be given, and it has the adaptability to be modified as needed.
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