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Retinopathy of Prematurity Computerized Screening and Monitoring System in a Tertiary Hospital in the Philippines
Edlyn S Naraval1, Jennifer Joy Y Santos-Rayos1, Maria Fe S Navarette1
1Department of Ophthalmology, Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines.
Insights
A new ROP monitoring system improved timely screenings for premature infants, preventing childhood blindness. This system ensures early detection and treatment of Retinopathy of Prematurity (ROP).
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Retinopathy of Prematurity (ROP) is a leading cause of preventable childhood blindness globally and in the Philippines.
- Early detection and prompt treatment are crucial for preventing vision loss from ROP.
- This study addresses the need for improved ROP screening protocols in premature infants.
Purpose of the Study:
- To prevent lifelong blindness in premature babies by ensuring timely ROP referrals, screenings, and treatment.
- To implement and evaluate a novel ROP monitoring and screening system.
- To reduce missed ROP screenings and improve referral accuracy.
Main Methods:
- An observational, single-center study was conducted from August 2022 to July 2023.
- A ROP monitoring and screening system with an automated computer alarm was developed and implemented.
- 241 admitted premature babies with ROP risk factors were enrolled.
Main Results:
- All 241 enrolled infants (100%) were screened for ROP.
- 15 infants (6%) were diagnosed with ROP upon initial screening.
- Timely referrals were achieved in 97% and timely screenings in 96% of cases.
Conclusions:
- The developed database and alarm system effectively facilitated timely interdepartmental referrals and screenings for premature infants at risk of ROP.
- The system proved to be a valuable tool for healthcare workers in managing ROP screening.
- ROP screenings are recommended for infants on assisted ventilation, and the system helps manage these cases effectively.
Background And Objective:
Retinopathy of Prematurity (ROP) is a significant cause of blindness in childhood. It is the leading cause of vision loss worldwide and 8.4% of childhood blindness in the Philippines. It is potentially avoidable if detected early and treated promptly. The study's objective was to prevent the dreaded complication of lifelong blindness from ROP in premature babies admitted at our institution by ensuring timely referrals, timely screenings, and prompt treatment.
Methods:
An observational, single-center study was conducted from August 2022 to July 2023. ROP monitoring and screening system with an automated computer alarm was developed. A total of 241 admitted babies with ROP risk factors were enrolled in the database. We were guided by the computer alarm system on the proper timing of referrals and screenings for ROP and detecting patients with missed screenings.
Results:
The study included 241 babies. All patients (100%) were screened for ROP. There were 15 (6%) patients diagnosed with ROP upon initial screening. For timeliness, 234 (97%) have timely referrals, and 232 (96%) have timely screenings. The most common reason for delayed referrals and screenings was waiting to wean patients off the ventilation support before referring them for ROP screening. No patient enrolled in the database missed ROP screening. However, in comparison with the total number of admissions with risk factors for ROP versus the total number of patients in the database, two (2%) were not enrolled in the database due to the resident's confusion in the ROP referral parameter (born term with low birth weight). Problems during the implementation were identified and addressed.
Conclusion:
The database and alarm system for monitoring and screening ROP was a helpful tool to healthcare workers for a timely interdepartmental referral and screening system for premature patients at risk for ROP. ROP screenings were recommended even if patients were hooked to assisted ventilation.
