Telemedicine approach to screening for severe retinopathy of prematurity - A pilot study
Telemedicine approach to screening for severe retinopathy of prematurity - A pilot study
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DOI：
10.1016/s0161-6420(03)00831-5
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发表时间：
2003-11-01
期刊：
影响因子：
13.7
通讯作者：
Hebert, M
中科院分区：
文献类型：
--
作者：
Ells, AL;Holmes, JM;Hebert, M
目的：评价数字视网膜照片的远程阅读在重度视网膜病变诊断中的应用。研究设计：前瞻性的纵向队列研究。受试者：44名有ROP风险的连续早产儿。方法：所有的婴儿都进行了纵向检查，经过一系列的检查，通过间接检眼镜检查（金标准）和使用RetCam-120数字视网膜照相机（MassieResearchLaboratories Inc.，都柏林，CA透镜。存储图像，并由蒙片读取器远程读取。转诊保证的ROP定义为1区的ROP、存在正疾病或存在任何3期ROP。我们确定是否以及何时转诊保证ROP被诊断为每只眼睛，每个婴儿，在每次检查，在每个婴儿的screening.Results的过程中：严重（转诊保证）ROP被诊断为23眼间接检眼镜在他们的一系列检查。数码摄影在检测转诊的ROP方面的敏感性为100%，特异性为96%.数码摄影的阳性预测值为92%，阴性预测值为100%。在87%的眼睛，转诊-保证ROP诊断数字摄影之前或同时作为间接ophthalmoscopic.Conclusions：纵向远程阅读的数字照片使用RetCam-120系统在检测转诊-保证ROP具有良好的特异性和敏感性。这项试点研究表明，远程阅读的数字照片有希望在ROP筛查的远程医疗策略。(C)2003年，美国眼科学会。
Purpose: To evaluate the use of remote reading of digital retinal photographs in the diagnosis of severe (referral-warranted) retinopathy of prematurity (ROP) during longitudinal screening for ROP.Study Design: Prospective, longitudinal cohort study.Subjects: Forty-four consecutive premature infants at risk for ROP.Methods: All infants were examined longitudinally, over a series of examinations, by indirect ophthalmoscopy (gold standard) and digital photography using the RetCam-120 Digital Retinal Camera (Massie Research Laboratories Inc., Dublin, CA) equipped with an ROP lens. Images were stored and read remotely by a masked reader. Referral-warranted ROP was defined as ROP in zone 1, the presence of plus disease or the presence of any stage 3 ROP. We determined whether and when referral -warranted ROP was diagnosed for each eye, of each infant, on each examination, during the course of each of the infant's screening.Results: Severe (referral -warranted) ROP was diagnosed in 23 eyes by indirect ophthalmoscopy during their series of examinations. Digital photography had a sensitivity of 100% and a specificity of 96% in detecting referral -warranted ROP. The positive predictive value of digital photography was 92%, and the negative predictive value was 100%. In 87% of eyes, referral -warranted ROP was diagnosed by digital photography before or at the same time as indirect ophthalmoscopy.Conclusions: Longitudinal remote reading of digital photographs using the RetCam-120 system has excellent specificity and sensitivity in detecting referral -warranted ROP. This pilot study has shown that remote reading of digital photographs has promise for telemedicine strategies in ROP screening. (C) 2003 by the American Academy of Ophthalmology.