Telemedicine for Retinopathy of Prematurity Diagnosis: Evaluation and Challenges

Richter, Grace M.; Williams, Steven L.; Starren, Justin; Flynn, John T.; Chiang, Michael F.

doi:10.1016/j.survophthal.2009.02.020

« Previous Next »Survey of Ophthalmology
Volume 54, Issue 6 , Pages 671-685, November 2009

Telemedicine for Retinopathy of Prematurity Diagnosis: Evaluation and Challenges

Grace M. Richter, MD
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York, USA
- Columbia University Mailman School of Public Health, New York, New York, USA
Steven L. Williams, MD
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York, USA
Justin Starren, MD, PhD
- Biomedical Informatics Research Center, Marshfield Clinic, Marshfield, Wisconsin, USA
- Department of Biomedical Informatics, Columbia University College of Physicians and Surgeons, New York, New York, USA
John T. Flynn, MD
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York, USA
Michael F. Chiang, MD
- Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York, USA
- Department of Biomedical Informatics, Columbia University College of Physicians and Surgeons, New York, New York, USA
- Reprint address: Michael F. Chiang, MD, Herbert Irving Assistant Professor of Ophthalmology and Biomedical Informatics, Columbia University College of Physicians and Surgeons, 635 West 165^th Street, Box 92, New York, NY 10032.

published online 10 August 2009.

Abstract

Retinopathy of prematurity (ROP) is a vasoproliferative disorder affecting low birth weight infants. Although timely diagnosis and treatment can significantly reduce the risk of severe complications, ROP remains a leading cause of childhood blindness worldwide. Limitations of current disease management strategies include extensive travel and logistical coordination requirements for ophthalmologists and neonatologists, decreasing availability of adequately trained ophthalmologists at the point of care, variability in how retinal findings are diagnosed and documented, and a growing need for ROP care worldwide. Store-and-forward telemedicine is an emerging technology by which medical data are captured for subsequent interpretation by a remote expert. This has potential to improve accessibility, quality, and cost of ROP management. In this article, we summarize the current evaluation data on applications of telemedicine for ROP, particularly involving the diagnostic accuracy and reliability of remote image interpretation by experts. We also address challenges such as the cost-effectiveness of telemedicine, and highlight potential barriers to implementation of these systems. Understanding these principles is essential to determine future directions in research and development of telemedicine systems for ROP, as well as for other ophthalmic diseases.

Key words: retinopathy of prematurity, telemedicine, diagnostic imaging, medical informatics, retina, diagnostic techniques and procedures, blindness

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The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in the article.

M.F.C. is supported by a Career Development Award from Research to Prevent Blindness (New York, NY) and by grant EY13972 from the National Institutes of Health (Bethesda, MD). MFC is an unpaid member of the Scientific Advisory Board for Clarity Medical Systems (Pleasanton, CA).

PII: S0039-6257(09)00065-4

doi:10.1016/j.survophthal.2009.02.020

« Previous Next »Survey of Ophthalmology
Volume 54, Issue 6 , Pages 671-685, November 2009

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