Telemedicine based screening of infants at risk for retinopathy of prematurity

Retinopathy of Prematurity (ROP) is a major risk for permanent visual loss in extreme prematures. In stage 3+ (zone I and II), defined as threshold di sease, the risk for retinal detachment with subsequent blindness is about 5 0% without treatment, compared to only a few percent with laser photoablati on. Visualisation and interpretation of the critical retinal changes requir es a high degree of expertise. Therefore, screening by general ophthalmolog ists will not identify all cases at threshold necessary to prevent blindnes s in as many infants as possible. The development of a new digital wide-fie ld camera system (RetCam 120) allows documentation of nearly the entire ret ina within minutes. Recently, sensitivity, specificity, positive predictive power and negative predictive power have been evaluated to be high. Data c ollection is also possible by trained staff of the neonatal care units. Dat a can be transferred electronically, even though it could be transferred th rough physical transport. Analyzing the data in a central reading center sp ecialized in the treatment of ROP will allow optimal timing of treatment an d thus salvage vision in more infants. In additon, unnecessary referrals th at are not only expensive but put also stress on the very vulnerable premat ures can be avoided. At present, efforts are made to realize a pilot project in Eastern Bavaria that will test the potentials of telemedicine based screening for ROP. In a ddition, the potential of the system will be evaluated in other neuroophtha lmological diseases.