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早产儿视网膜病变的远程医疗

Telemedicine for Retinopathy of Prematurity.

作者信息

Brady Christopher J, D'Amico Samantha, Campbell J Peter

机构信息

Division of Ophthalmology, Department of Surgery, Larner College of Medicine, University of Vermont, Burlington, Vermont.

Division of Ophthalmology, Department of Surgery, University of Vermont Medical Center, Burlington, Vermont.

出版信息

Telemed J E Health. 2020 Apr;26(4):556-564. doi: 10.1089/tmj.2020.0010. Epub 2020 Mar 25.

Abstract

Background:Retinopathy of prematurity (ROP) is a disease of the retinal vasculature that remains a leading cause of childhood blindness worldwide despite improvements in the systemic care of premature newborns. Screening for ROP is effective and cost-effective, but in many areas, access to skilled examiners to conduct dilated examinations is poor. Remote screening with retinal photography is an alternative strategy that may allow for improved ROP care.

Methods:The current literature was reviewed to find clinical trials and expert consensus documents on the state-of-the-art of telemedicine for ROP.

Results:Several studies have confirmed the utility of telemedicine for ROP. In addition, several clinical studies have reported favorable long-term results. Many investigators have reinforced the need for detailed protocols on image acquisition and image interpretation.

Conclusions:Telemedicine for ROP appears to be a viable alternative to live ophthalmoscopic examinations in many circumstances. Standardization and documentation afforded by telemedicine may provide additional benefits to providers and their patients. With continued improvements in image quality and affordability of imaging systems as well as improved automated image interpretation tools anticipated in the near future, telemedicine for ROP is expected to play an expanding role for a uniquely vulnerable patient population.

摘要

背景

早产儿视网膜病变(ROP)是一种视网膜血管疾病,尽管早产新生儿的全身护理有所改善,但它仍是全球儿童失明的主要原因。ROP筛查有效且具有成本效益,但在许多地区,获得熟练检查人员进行散瞳检查的机会很差。视网膜摄影远程筛查是一种替代策略,可能会改善ROP的护理。

方法

回顾当前文献,以查找关于ROP远程医疗最新技术的临床试验和专家共识文件。

结果

多项研究证实了远程医疗对ROP的实用性。此外,多项临床研究报告了良好的长期结果。许多研究人员强调了需要关于图像采集和图像解释的详细方案。

结论

在许多情况下,ROP远程医疗似乎是现场检眼镜检查的可行替代方案。远程医疗提供的标准化和文档记录可能会为提供者及其患者带来额外益处。随着图像质量和成像系统可负担性的持续改善,以及预计在不久的将来会有改进的自动图像解释工具,ROP远程医疗有望在这一特别脆弱的患者群体中发挥越来越大的作用。

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