Zhang Xinxin, Wang Yuping, Ulrich J Niklas, Yang Yi, Ding Leona, Yang Yi, Xu Ding, Tarczy-Hornoch Kristina, Cabrera Michelle T
a University of North Carolina School of Medicine , Chapel Hill , NC , USA.
b Department of Ophthalmology , Second Hospital of Lanzhou University , Lanzhou , China.
Ophthalmic Epidemiol. 2018 Apr;25(2):120-125. doi: 10.1080/09286586.2017.1368671. Epub 2017 Nov 2.
To determine the incidence of retinopathy of prematurity (ROP) in Gansu, China by combining bedside examinations with remote RetCam (Clarity Medical Systems, Pleasanton, CA, USA) diagnosis.
ROP screening via indirect ophthalmoscopy followed by RetCam imaging was performed from 2014 to 2015. Three ROP-experienced ophthalmologists interpreted images remotely. Incidence of ROP was determined by combining bedside and telemedicine diagnoses.
Of 139 examined infants and 137 complete records, 20 (14.6%) patients developed ROP, with 11 (8.0%) stage 1, six (4.4%) stage 2, and three (2.2%) stage 3 based on combined diagnoses. Perinatal asphyxia was significantly associated with ROP incidence (p = 0.01). ROP incidence by combined diagnosis (20/137 or 14.6%) versus clinician diagnosis alone (21/137 or 15.3%, p = 0.50) was similar. Telemedicine changed diagnoses in 4/21 (19.0%) ROP cases.
Telemedicine may be helpful in confirming ROP incidence and may serve as a training and support model for less experienced and professionally isolated ROP examiners.
通过将床旁检查与远程RetCam（美国加利福尼亚州普莱森顿市Clarity Medical Systems公司）诊断相结合，确定中国甘肃省早产儿视网膜病变（ROP）的发病率。
2014年至2015年期间，通过间接检眼镜检查进行ROP筛查，随后进行RetCam成像。三名有ROP诊断经验的眼科医生对图像进行远程解读。通过结合床旁诊断和远程医疗诊断来确定ROP的发病率。
在139名接受检查的婴儿中，有137份完整记录，根据综合诊断，20名（14.6%）患者发生了ROP，其中11名（8.0%）为1期，6名（4.4%）为2期，3名（2.2%）为3期。围产期窒息与ROP发病率显著相关（p = 0.01）。综合诊断的ROP发病率（20/137或14.6%）与仅由临床医生诊断的发病率（21/137或15.3%，p = 0.50）相似。远程医疗在4/21（19.0%）的ROP病例中改变了诊断结果。
远程医疗可能有助于确认ROP发病率，并可作为经验不足和专业上相对孤立的ROP检查人员的培训和支持模式。
