Pediatrics. 2015 Jan;135(1):e238-54. doi: 10.1542/peds.2014-0978.
Retinopathy of prematurity (ROP) remains a significant threat to vision for extremely premature infants despite the availability of therapeutic modalities capable, in most cases, of managing this disorder. It has been shown in many controlled trials that application of therapies at the appropriate time is essential to successful outcomes in premature infants affected by ROP. Bedside binocular indirect ophthalmoscopy has been the standard technique for diagnosis and monitoring of ROP in these patients. However, implementation of routine use of this screening method for at-risk premature infants has presented challenges within our existing care systems, including relative local scarcity of qualified ophthalmologist examiners in some locations and the remote location of some NICUs. Modern technology, including the development of wide-angle ocular digital fundus photography, coupled with the ability to send digital images electronically to remote locations, has led to the development of telemedicine-based remote digital fundus imaging (RDFI-TM) evaluation techniques. These techniques have the potential to allow the diagnosis and monitoring of ROP to occur in lieu of the necessity for some repeated on-site examinations in NICUs. This report reviews the currently available literature on RDFI-TM evaluations for ROP and outlines pertinent practical and risk management considerations that should be used when including RDFI-TM in any new or existing ROP care structure.
早产儿视网膜病变（ROP）仍然是极早产儿视力的重大威胁，尽管有多种治疗方法可用于治疗这种疾病。许多对照试验表明，在适当的时间应用治疗方法对于接受 ROP 治疗的早产儿的成功结局至关重要。床边双目间接检眼镜一直是这些患者诊断和监测 ROP 的标准技术。然而，在现有的护理系统中，常规使用这种筛查方法存在挑战，包括在某些地区相对缺乏合格的眼科检查人员以及一些 NICU 位置偏远。现代技术，包括广角眼部数字眼底摄影的发展，以及将数字图像电子传输到远程位置的能力，导致了基于远程医疗的远程数字眼底成像（RDFI-TM）评估技术的发展。这些技术有可能使 ROP 的诊断和监测得以实现，而无需在 NICU 进行一些重复的现场检查。本报告回顾了目前关于 RDFI-TM 评估 ROP 的文献，并概述了在任何新的或现有的 ROP 护理结构中纳入 RDFI-TM 时应考虑的相关实用和风险管理问题。
