Trained Evaluators Can Successfully Screen for Premie Eye Disease from Miles Away

Trained Evaluators Can Successfully Screen for Premie Eye Disease from Miles Away

Narrator: Could a technician in Philadelphia prevent a premature baby in Minneapolis from going blind just by looking at photos of the babies’ eyes? A new study funded by the National Eye Institute suggests it's possible.

Premature babies are at risk of going blind from a condition called retinopathy of prematurity, also known as ROP. ROP is treatable, but only if it is detected in time.

Graham E. Quinn, MD: So if you detect it you have a good chance of treating it. And with treatment you have a good chance to prevent blindness

Narrator: The problem? Many hospitals have a shortage of qualified ophthalmologists to monitor babies for ROP. Of the half million or so babies born prematurely in the U.S. each year only a small fraction will need treatment, but all babies born at less than 31 weeks of pregnancy or who weigh less than 3.3 pounds at birth need monitoring for ROP.

Monitoring all those babies takes time. Doctor Quinn led a study called e-ROP to determine if monitoring could be accomplished by telemedicine.

Graham E. Quinn, MD: What we are calling it is e-ROP because we electronically send the images to a central center where they’re graded by graders who do not see the baby, but they see the images from the baby.

Narrator: In ROP blood vessels in the tissue in the back of the eye called the retina begin to grow abnormally which can lead to scarring and detachment of the retina. Treatment involves destroying the abnormal blood vessels with lasers or freezing them using a technique called cryoablation.

The study took place during the usual care of more than 1,200 premature infants at 13 clinical centers. Whenever an ophthalmologist examined one of the babies in the study, another staff member used a special camera to take pictures of the babies' retinas.

Image readers at the University of Pennsylvania who were trained to identify ROP then judged which infants they thought had signs of the disease. The investigators then compared the conclusions made by the image readers to the conclusions made by the ophthalmologists.

Graham E. Quinn, MD: We found that there was very good likelihood of agreement between the diagnostic examination by the doctor and gradings from the trained readers.

Narrator: Telemedicine screening for ROP could have several benefits. It can be done more frequently than screening by an ophthalmologist who may have limited availability depending on location.

Telemedicine may catch ROP earlier. In the study image readers identified 43 percent of advanced ROP cases on average about 15 days earlier than the ophthalmologists.

And telemedicine could bring down the cost of ROP screening by reducing the demands on ophthalmologists whose time is better allocated to babies who need their attention and expertise.

Graham E. Quinn, MD: NEI had the foresight to say it's a valuable study for us to do, and Ellie Schron and the people in the clinical side of NEI were so helpful in making us aware of the importance of it — not that that had to be reinforced a lot — but understanding the importance of it and really supporting our efforts in just a very positive way.