Fijalkowski Natalia, Zheng Luo Luo, Henderson Michael T, Wang Sean K, Wallenstein Matthew B, Leng Theodore, Moshfeghi Darius M
Ophthalmic Surg Lasers Imaging Retina. 2014 Mar-Apr;45(2):106-13. doi: 10.3928/23258160-20140122-01. Epub 2014 Jan 20.
To report the 5-year results of the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) telemedicine initiative.
Infants requiring retinopathy of prematurity (ROP) screening at six neonatal intensive care units from December 1, 2005, to November 30, 2010, were evaluated with remote retinal photography by an ROP specialist. Every infant received outpatient binocular indirect ophthalmoscope examinations until termination criteria were achieved or until treatment. Outcomes were treatment-warranted ROP (TW-ROP, ETROP type 1) and adverse anatomical events.
Five hundred eleven infants (1,022 eyes) were screened. Fifteen infants had TW-ROP and underwent laser photocoagulation. The TW-ROP cohort had significantly lower birth weight and gestational age (both P < .001). No patient progressed to adverse anatomical outcomes and no case of TW-ROP was missed. Tele-medicine had 100% sensitivity, 99.8% specificity, 93.8% positive predictive value, and 100% negative predictive value for detection of TW-ROP.
Telemedicine demonstrates high diagnostic accuracy for detection of TW-ROP and can complement ROP screening.
报告斯坦福大学早产儿视网膜病变诊断网络（SUNDROP）远程医疗计划的5年结果。
对2005年12月1日至2010年11月30日期间在6个新生儿重症监护病房需要进行早产儿视网膜病变（ROP）筛查的婴儿，由一名ROP专家通过远程视网膜摄影进行评估。每个婴儿均接受门诊双目间接检眼镜检查，直至达到终止标准或接受治疗。结局指标为需要治疗的ROP（TW-ROP，ETROP 1型）和不良解剖学事件。
共筛查511例婴儿（1022只眼）。15例婴儿患有TW-ROP并接受了激光光凝治疗。TW-ROP队列的出生体重和胎龄显著更低（均P < .001）。无患者进展为不良解剖学结局，且未漏诊任何TW-ROP病例。远程医疗检测TW-ROP的灵敏度为100%、特异度为99.8%、阳性预测值为93.8%、阴性预测值为100%。
远程医疗在检测TW-ROP方面显示出较高的诊断准确性，可作为ROP筛查的补充手段。
