Al-Abaiji Hajer A, Bangsgaard Regitze, Kofod Mads, Faber Carsten, Larsen Ann-Cathrine, Brost Agnes Galbo, Slidsborg Carina, Klemp Kristian, Breindahl Morten, la Cour Morten Dornonville de, Kessel Line
Department of Ophthalmology, Copenhagen University Hospital-Rigshospitalet, 2100 Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark.
J Pers Med. 2024 Sep 24;14(10):1020. doi: 10.3390/jpm14101020.
: This study investigates the feasibility of implementing telescreening for retinopathy of prematurity (ROP) using the ICON GO widefield camera operated by a non-physician healthcare professional (NPHP). We hypothesized that images captured by an NPHP are adequate to evaluate ROP changes without further examinations. Secondly, the level of agreement between independent ROP graders were evaluated based on the fundus photographs. : National ROP screening criteria were gestational age (GA) < 32 weeks or birthweight (BW) < 1500 g. Exclusion criteria were children hospitalized and born outside the Capital Region and examinations not performed by an NPHP. The screenings were performed using the ICON GO. The NPHP selected the best images for evaluation by an -site ophthalmologist, regarding whether re-examination was necessary and if so, whether the re-examination was beneficial. Lastly, the images were re-evaluated by an independent -site ophthalmologist. : A total of 415 screening sessions on 165 patients performed by an NPHP were included. Re-examination was necessary in three screening sessions and beneficial in two. The level of agreement between the -site and -site ophthalmologists regarding ROP screening outcome was = 0.82, ROP stage = 0.69, plus disease = 0.69, and lastly ROP zone = 0.37. Of the screened children, ninety-seven (58.8%) had no ROP at any time points, sixty-two (37.6%) had some stage of ROP not requiring treatment, and six (3.6%) received ROP treatment. : Telemedicine screening for ROP with the ICON GO camera performed by an NPHP was feasible with an almost-perfect agreement and negligible need for re-examinations. The approach effectively identified children needing treatment, supporting the use of telescreening in ROP management.
本研究探讨了由非医师医疗保健专业人员(NPHP)操作ICON GO广角相机对早产儿视网膜病变(ROP)实施远程筛查的可行性。我们假设NPHP拍摄的图像足以评估ROP变化,无需进一步检查。其次,基于眼底照片评估了独立ROP分级者之间的一致性水平。国家ROP筛查标准为胎龄(GA)<32周或出生体重(BW)<1500克。排除标准为在首都地区以外住院和出生的儿童以及非NPHP进行的检查。筛查使用ICON GO进行。NPHP选择最佳图像供现场眼科医生评估,确定是否需要重新检查,以及如果需要,重新检查是否有益。最后,由独立的现场眼科医生对图像进行重新评估。纳入了由NPHP对165名患者进行的共415次筛查。三次筛查需要重新检查,两次重新检查有益。现场和现场眼科医生在ROP筛查结果方面的一致性水平为κ=0.82,ROP分期κ=0.69,附加疾病κ=0.69,最后ROP区域κ=0.37。在接受筛查的儿童中,97名(58.8%)在任何时间点均无ROP,62名(37.6%)有某种程度的ROP但无需治疗,6名(3.6%)接受了ROP治疗。由NPHP使用ICON GO相机进行的ROP远程医疗筛查是可行的,一致性几乎完美,重新检查的需求可忽略不计。该方法有效识别了需要治疗的儿童,支持在ROP管理中使用远程筛查。