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American Academy of Pediatrics
Article

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 and for the e-ROP Study Cooperative Group
Pediatrics December 2015, peds.2015-2256; DOI: https://doi.org/10.1542/peds.2015-2256
Alex R. Kemper
aDuke Clinical Research Institute, Durham, North Carolina;
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Lisa A. Prosser
bChild Health Evaluation and Research Unit, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan;
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Kelly C. Wade
cDepartment of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania;
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Michael X. Repka
dDepartment of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland;
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Gui-shuang Ying
eCenter for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, Philadelphia, Pennsylvania; and
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Agnieshka Baumritter
fDivision of Pediatric Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
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Graham E. Quinn
fDivision of Pediatric Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
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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 studyof 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.

  • Accepted October 23, 2015.
  • Copyright © 2016 by the American Academy of Pediatrics

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Pediatrics
Vol. 147, Issue 1
1 Jan 2021
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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, for the e-ROP Study Cooperative Group
Pediatrics Dec 2015, peds.2015-2256; DOI: 10.1542/peds.2015-2256

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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, for the e-ROP Study Cooperative Group
Pediatrics Dec 2015, peds.2015-2256; DOI: 10.1542/peds.2015-2256
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