gms | German Medical Science

Prompt laser photocoagulation of treatment-requiring acute ROP is key to prevent severe visual handicap in high risk prematures. Timely detection and correct interpretation of acute ROP is hampered by enrolling ophthalmologists with limited experience in the screening process [1]. Digital wide-field imaging based telemedicine and software-based data analysis could optimize the detection of treatment-requiring acute ROP.

Several studies including our own East-Bavarian Multicenter Telemedicine Project to detect treatment-requiring ROP have been conducted to evaluate the sensitivity and specificity to detect referral-warranted ROP stages with the use of digital wide-field imaging using the RetCam120, and comparing the results with conventional screening using binocular indirect ophthalmoscopy BIO. Sensitivity and specificity of digital wide-field imaging to detect referral-warranted ROP was high when longitudinal screening was performed according to the national and international guidelines for screening [2], [3]. Within the East-Bavarian Multicenter Telemedicine Project customized software DiNO has been developed to allow standardized evaluation of digital wide-field fundus images and archiving of the paediatric data. It includes a dynamic grid positioning feature that can be superimposed to all images from the same eye and a semi-automatic quantification of the ROP stages per zone and clock hour. DiNO detected referral-warranted ROP one to 4 weeks earlier than BIO in 35%, at the same time in 61%, and one week later in 4% (125 examinations, 26 infants [4]).

Digital wide-field imaging based telemedicine and customized software for data analysis is shown to optimize detection of referral-warranted acute ROP.