A Comparison of Strategies for Retinopathy of Prematurity Detection
Alex R Kemper, Lisa A Prosser, Kelly C Wade, Michael X Repka, Gui-shuang Ying, Agnieshka Baumritter, Graham E Quinn, e-ROP Study Cooperative Group, Graham E Quinn, Kelly Wade, Agnieshka Baumritter, Trang B Duros, Lisa Erbring, Michael X Repka, Jennifer A Shepard, David Emmert, C Mark Herring, Deborah VanderVeen, Suzanne Johnston, Carolyn Wu, Jason Mantagos, Danielle Ledoux, Tamar Winter, Frank Weng, Theresa Mansfield, Don L Bremer, Mary Lou McGregor, Catherine Olson Jordan, David L Rogers, Rae R Fellows, Suzanne Brandt, Brenda Mann, David Wallace, Sharon Freedman, Sarah K Jones, Du Tran-Viet, Rhonda Michelle Young, Charles C Barr, Rahul Bhola, Craig Douglas, Peggy Fishman, Michelle Bottorff, Brandi Hubbuch, Rachel Keith, Erick D Bothun, Inge DeBecker, Jill Anderson, Ann Marie Holleschau, Nichole E Miller, Darla N Nyquist, R Michael Siatkowski, Lucas Trigler, Marilyn Escobedo, Karen Corff, Michelle Huynh, Kelli Satnes, Monte D Mills, Will Anninger, Gil Binenbaum, Graham Quinn, Karen A Karp, Denise Pearson, Alice Gong, John Stokes, Clio Armitage Harper, Laurie Weaver, Carmen McHenry, Kathryn Conner, Rosalind Heemer, Elnora Cokley, Robert Hoffman, David Dries, Katie Jo Farnsworth, Deborah Harrison, Bonnie Carlstrom, Cyrie Ann Fry, David Morrison, Sean Donahue, Nancy Benegas, Sandy Owings, Sandra Phillips, Scott Ruark, Anna Ells, Patrick Mitchell, April Ingram, Rosie Sorbie, Gui-shuang Ying, Maureen Maguire, Mary Brightwell-Arnold, Maxwell Pistilli, Kathleen McWilliams, Sandra Harkins, Ebenezer Daniel, E Revell Martin, Candace R Parker Ostroff, Krista Sepielli, Eli Smith, Claressa Whearry, Antonio Capone, G Baker Hubbard, Anna Ells, Peter Lloyd Hildebrand, Kerry Davis, G Carl Gibson, Regina Hansen, David C Musch, Stephen P Christiansen, Ditte J Hess, Steven M Kymes, Srinivas R Sadda, Ryan Spaulding, Eleanor B Schron, Alex R Kemper, Lisa A Prosser, Kelly C Wade, Michael X Repka, Gui-shuang Ying, Agnieshka Baumritter, Graham E Quinn, e-ROP Study Cooperative Group, Graham E Quinn, Kelly Wade, Agnieshka Baumritter, Trang B Duros, Lisa Erbring, Michael X Repka, Jennifer A Shepard, David Emmert, C Mark Herring, Deborah VanderVeen, Suzanne Johnston, Carolyn Wu, Jason Mantagos, Danielle Ledoux, Tamar Winter, Frank Weng, Theresa Mansfield, Don L Bremer, Mary Lou McGregor, Catherine Olson Jordan, David L Rogers, Rae R Fellows, Suzanne Brandt, Brenda Mann, David Wallace, Sharon Freedman, Sarah K Jones, Du Tran-Viet, Rhonda Michelle Young, Charles C Barr, Rahul Bhola, Craig Douglas, Peggy Fishman, Michelle Bottorff, Brandi Hubbuch, Rachel Keith, Erick D Bothun, Inge DeBecker, Jill Anderson, Ann Marie Holleschau, Nichole E Miller, Darla N Nyquist, R Michael Siatkowski, Lucas Trigler, Marilyn Escobedo, Karen Corff, Michelle Huynh, Kelli Satnes, Monte D Mills, Will Anninger, Gil Binenbaum, Graham Quinn, Karen A Karp, Denise Pearson, Alice Gong, John Stokes, Clio Armitage Harper, Laurie Weaver, Carmen McHenry, Kathryn Conner, Rosalind Heemer, Elnora Cokley, Robert Hoffman, David Dries, Katie Jo Farnsworth, Deborah Harrison, Bonnie Carlstrom, Cyrie Ann Fry, David Morrison, Sean Donahue, Nancy Benegas, Sandy Owings, Sandra Phillips, Scott Ruark, Anna Ells, Patrick Mitchell, April Ingram, Rosie Sorbie, Gui-shuang Ying, Maureen Maguire, Mary Brightwell-Arnold, Maxwell Pistilli, Kathleen McWilliams, Sandra Harkins, Ebenezer Daniel, E Revell Martin, Candace R Parker Ostroff, Krista Sepielli, Eli Smith, Claressa Whearry, Antonio Capone, G Baker Hubbard, Anna Ells, Peter Lloyd Hildebrand, Kerry Davis, G Carl Gibson, Regina Hansen, David C Musch, Stephen P Christiansen, Ditte J Hess, Steven M Kymes, Srinivas R Sadda, Ryan Spaulding, Eleanor B Schron
Abstract
Background and objectives: Delayed detection of type 1 retinopathy of prematurity (ROP) can lead to permanent visual impairment. Providing ROP examinations is challenging because of the limited ophthalmology workforce. This study compares digital imaging-based ROP detection strategies versus serial ROP examinations.
Methods: We conducted an individual-level microsimulation study of a hypothetical cohort of 650 infants with gestational age from 23 to 30 weeks. Infants were evaluated by using strategies based on indirect ophthalmoscopy or digital imaging beginning at 32 weeks' postmenstrual age (PMA) and continuing to discharge, transfer, or 40 weeks' PMA. ROP status and the accuracy of digital imaging were based on the e-ROP (Telemedicine Approaches to Evaluating Acute-Phase ROP) study, which enrolled high-risk infants.
Results: Within the hypothetical NICU, the strategy of ROP examinations identified an average of 45.8 cases of type 1 ROP by discharge, transfer, or 40 weeks' PMA, and another 1.9 cases were included in the group of infants recommended to have later follow-up. Digital imaging with an ROP examination at discharge identified all 47.7 cases of type 1 ROP. On average, the ROP examination-only strategy required 1745.7 ROP examinations, whereas digital imaging with a discharge examination required 1065.5 ROP examinations and 1786.2 digital imaging sessions.
Conclusions: Although digital imaging decreased the number of ROP examinations per infant, there was an increase in the total number of interventions (ie, ROP examinations and imaging sessions). Providing an ROP examination at the time of NICU discharge can significantly reduce the number of infants who require follow-up.
Trial registration: ClinicalTrials.gov NCT01264276.
Conflict of interest statement
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
Copyright © 2016 by the American Academy of Pediatrics.
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Source: PubMed