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Outcome of real-time telescreening for retinopathy of prematurity using videoconferencing in a community setting in
Tapas R Padhi1, Souvik Bhunia1, Taraprasad Das2
1Vitreoretinal Services, Anant Bajaj Retina Institute, Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneswar, Odisha, India.
Insights
Real-time retinopathy of prematurity (ROP) telescreening via videoconferencing is effective in rural India. This strategy saves significant time and travel for specialists and parents, while accurately detecting ROP needing treatment.
Area of Science:
- Ophthalmology
- Telemedicine
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Early detection and treatment are crucial for preventing vision loss.
- Access to ROP specialists is limited in many community settings, particularly in rural areas.
Purpose of the Study:
- To assess the feasibility and outcomes of a real-time ROP telescreening program.
- To evaluate the use of videoconferencing for remote ROP diagnosis and parental counseling.
- To determine the effectiveness of this strategy in a community setting in India.
Main Methods:
- Prospective study involving trained ophthalmic personnel capturing fundus images.
- Real-time image analysis and parental counseling by a remote ROP specialist via videoconferencing.
- Comparison with bedside indirect ophthalmoscopy for a subset of infants.
Main Results:
- 576 infants (1152 eyes) screened over 9 months in rural India.
- High sensitivity (97.2%) and negative predictivity (92.7%) for detecting treatment-warranting ROP.
- Significant savings in travel time for both ROP specialists and parents, along with cost reduction.
Conclusions:
- Real-time ROP telescreening using videoconferencing is a sensitive and effective strategy.
- The audiovisual connection facilitates optimal imaging supervision and training.
- This approach conserves skilled workforce time and enhances direct communication with parents.
Purpose:
To evaluate the feasibility and outcome of a real-time retinopathy of prematurity (ROP) telescreening strategy using videoconferencing in a community setting in India.
Method:
In a prospective study, trained allied ophthalmic personnel obtained the fundus images in the presence of the parents and local childcare providers. Analysis of images and parental counseling were done in real time by an ROP specialist located at a tertiary center using videoconferencing software. A subset of babies was also examined using bedside indirect ophthalmoscopy by an ROP care-trained ophthalmologist. The data were analyzed using descriptive statistics, sensitivity, specificity, positive and negative predictive values, and correlation coefficient.
Results:
Over 9 months, we examined 576 babies (1152 eyes) in six rural districts of India. The parents accepted the model as they recognized that a remotely located specialist was evaluating all images in real time. The strategy saved the travel time for ROP specialists by 477 h (47.7 working days) and for parents (47,406 h or 1975.25 days), along with the associated travel cost. In a subgroup analysis (100 babies, 200 eyes), the technology had a high sensitivity (97.2%) and negative predictivity value (92.7%). It showed substantial agreement (k = 0.708) with the bedside indirect ophthalmoscopy by ROP specialists with respect to the detection of treatment warranting ROP. Also, the strategy helped train the participants.
Conclusion:
Real-time ROP telescreening using videoconferencing is sensitive enough to detect treatment warranting ROPs and saves skilled workforce and time. The real-time audiovisual connection allows optimal supervision of imaging, provides excellent training opportunities, and connects ophthalmologists directly with the parents.
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