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奥克兰地区远程医疗早产儿视网膜病变筛查网络:十年回顾。

Auckland regional telemedicine retinopathy of prematurity screening network: A 10-year review.

机构信息

Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

Department of Ophthalmology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand.

出版信息

Clin Exp Ophthalmol. 2019 Dec;47(9):1122-1130. doi: 10.1111/ceo.13593. Epub 2019 Aug 7.

Abstract

IMPORTANCE

Retinopathy of prematurity (ROP) is a potentially blinding condition affecting the retinae of premature infants. Effective screening is necessary for timely treatment.

BACKGROUND

The Auckland Regional Telemedicine ROP (ART-ROP) network, utilizes wide-field digital imaging for ROP screening. This study reviews the ART-ROP network.

DESIGN

Retrospective analysis of the ART-ROP database.

PARTICIPANTS

Files of infants in ART-ROP from 2006 to 2015.

METHODS

Data on infant demographics, ROP stage, treatment and outcome was collected.

MAIN OUTCOME MEASURES

The efficacy of ART-ROP in the management of ROP.

RESULTS

A review of 1181 infants across three neonatal intensive care units, was completed. Infants had a mean of four screening sessions with no infants who met ROP screening criteria being missed. Type 1 ROP was present in 83 infants, who had significantly lower average birth weight 786 ± 191 g compared to 1077 ± 285 g (P < .001), and gestational age 25.3 ± 1.7 weeks compared to 27.8 ± 2.2 weeks (P < .001) than the screened cohort. The number of infants requiring screening increased (R = .7993), yet treatment rates decreased (R = .9205) across the time period. Out-patient clinic follow-up was attended by 75.10% of infants screened and there was no missed ROP in those infants seen.

CONCLUSIONS AND RELEVANCE

ART-ROP solely uses wide-field digital imaging for ROP diagnosis, and management, including discharge, of infants. This detailed review of ART-ROP indicates an increase in screening demand, but a decrease in the rate of type 1 ROP. The ART-ROP telemedicine model demonstrates real potential to address workforce shortage in ROP screening.

摘要

重要性

早产儿视网膜病变(ROP)是一种潜在致盲的疾病,影响早产儿的视网膜。有效的筛查对于及时治疗至关重要。

背景

奥克兰区域远程医疗 ROP(ART-ROP)网络利用广角数字成像进行 ROP 筛查。本研究回顾了 ART-ROP 网络。

设计

ART-ROP 数据库的回顾性分析。

参与者

来自 2006 年至 2015 年的 ART-ROP 婴儿的文件。

方法

收集婴儿人口统计学、ROP 分期、治疗和结局的数据。

主要观察指标

ART-ROP 在 ROP 管理中的疗效。

结果

对三家新生儿重症监护病房的 1181 名婴儿进行了回顾。婴儿平均进行了四次筛查,没有错过符合 ROP 筛查标准的婴儿。83 名婴儿存在 1 型 ROP,他们的平均出生体重明显较低(786±191g),低于筛查队列的 1077±285g(P<0.001),且胎龄也较短(25.3±1.7 周),低于筛查队列的 27.8±2.2 周(P<0.001)。在此期间,需要筛查的婴儿数量增加(R=0.7993),但治疗率下降(R=0.9205)。接受筛查的婴儿中有 75.10%参加了门诊随访,在这些婴儿中没有漏诊 ROP。

结论和相关性

ART-ROP 仅使用广角数字成像进行 ROP 诊断和管理,包括出院。对 ART-ROP 的详细回顾表明筛查需求增加,但 1 型 ROP 的发生率下降。ART-ROP 远程医疗模式在解决 ROP 筛查劳动力短缺方面具有巨大潜力。

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