Graham E Quinn1, Gui-Shuang Ying2, Michael X Repka3, R Michael Siatkowski4, Robert Hoffman5, Monte D Mills6, David Morrison7, Ebenezer Daniel2, Agnieshka Baumritter8, P Lloyd Hildebrand3, Eleanor B Schron9, Anna L Ells10, Kelly Wade6, Alex R Kemper11. 1. Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Pediatric Ophthalmology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: quinn@email.chop.edu. 2. Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania. 3. Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland. 4. Dean McGee Eye Institute, University of Oklahoma, Oklahoma City. 5. Department of Ophthalmology, University of Utah, Salt Lake City. 6. Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania; Division of Pediatric Ophthalmology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 7. Department of Ophthalmology, Vanderbilt University, Nashville, Tennessee. 8. Division of Pediatric Ophthalmology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 9. National Eye Institute, Bethesda, Maryland. 10. Department of Ophthalmology, University of Calgary, Canada. 11. Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.
Abstract
PURPOSE: To examine the feasibility of a retinopathy of prematurity (ROP) telemedicine evaluation system of providing timely feedback to a neonatal intensive care unit (NICU) with at-risk premature infants. METHODS: This was a prospective observational study of premature infants with birth weights of <1251 g in five NICUs in the United States. Infants scheduled for clinically indicated ROP evaluations underwent indirect ophthalmoscopic examinations and digital imaging on the same day. Imaging was performed by nonphysician retinal imagers. Times required were determined from obtaining digital images of both eyes to submission via web-based system to a secure server for grading by trained readers at a central reading center to sending back grading results to the clinical center. RESULTS: A total of 1,642 image sets of eyes of 292 infants were obtained, from 823 imaging sessions. The mean turnaround time from submission of image sets of both eyes to return of the grading results to the clinical center was 10.1 ± 11.3 hours (standard deviation), with a median of 12.0 hours (1st quartile, 0.9 hours; 3rd quartile, 16 hours). Overall, 95.5% of gradings (95% CI, 93.9%-96.7%) were returned within 24 hours. Subgroup analyses found, for image sets submitted to the reading center before 2 p.m. Eastern Standard Time, median time to report was 1.7 hours (1st quartile, 0.7 hours; 3rd quartile, 15.5 hours) compared with those submitted after 2pm (median, 14.1 hours; 1st quartile, 11.2, hours; 3rd quartile, 16.3 hours). CONCLUSIONS: An ROP telemedicine approach can provide timely feedback to the NICU regarding the detection of potentially serious ROP and thus referral to an ophthalmologist for examination and consideration of treatment.
PURPOSE: To examine the feasibility of a retinopathy of prematurity (ROP) telemedicine evaluation system of providing timely feedback to a neonatal intensive care unit (NICU) with at-risk premature infants. METHODS: This was a prospective observational study of premature infants with birth weights of <1251 g in five NICUs in the United States. Infants scheduled for clinically indicated ROP evaluations underwent indirect ophthalmoscopic examinations and digital imaging on the same day. Imaging was performed by nonphysician retinal imagers. Times required were determined from obtaining digital images of both eyes to submission via web-based system to a secure server for grading by trained readers at a central reading center to sending back grading results to the clinical center. RESULTS: A total of 1,642 image sets of eyes of 292 infants were obtained, from 823 imaging sessions. The mean turnaround time from submission of image sets of both eyes to return of the grading results to the clinical center was 10.1 ± 11.3 hours (standard deviation), with a median of 12.0 hours (1st quartile, 0.9 hours; 3rd quartile, 16 hours). Overall, 95.5% of gradings (95% CI, 93.9%-96.7%) were returned within 24 hours. Subgroup analyses found, for image sets submitted to the reading center before 2 p.m. Eastern Standard Time, median time to report was 1.7 hours (1st quartile, 0.7 hours; 3rd quartile, 15.5 hours) compared with those submitted after 2pm (median, 14.1 hours; 1st quartile, 11.2, hours; 3rd quartile, 16.3 hours). CONCLUSIONS: An ROP telemedicine approach can provide timely feedback to the NICU regarding the detection of potentially serious ROP and thus referral to an ophthalmologist for examination and consideration of treatment.
Authors: Kelly C Wade; Maxwell Pistilli; Agnieshka Baumritter; Karen Karp; Alice Gong; Alex R Kemper; Gui-Shuang Ying; Graham Quinn Journal: J Pediatr Date: 2015-08-20 Impact factor: 4.406
Authors: Ebenezer Daniel; Graham E Quinn; P Lloyd Hildebrand; Anna Ells; G Baker Hubbard; Antonio Capone; E Revell Martin; Candace P Ostroff; Eli Smith; Maxwell Pistilli; Gui-Shuang Ying Journal: JAMA Ophthalmol Date: 2015-06 Impact factor: 7.389
Authors: James D Reynolds; Velma Dobson; Graham E Quinn; Alistair R Fielder; Earl A Palmer; Richard A Saunders; Robert J Hardy; Dale L Phelps; John D Baker; Michael T Trese; David Schaffer; Betty Tung Journal: Arch Ophthalmol Date: 2002-11
Authors: Anna L Ells; Jonathan M Holmes; William F Astle; Geoff Williams; David A Leske; Michael Fielden; Brad Uphill; Penny Jennett; Marilynne Hebert Journal: Ophthalmology Date: 2003-11 Impact factor: 12.079
Authors: Graham E Quinn; Gui-shuang Ying; Ebenezer Daniel; P Lloyd Hildebrand; Anna Ells; Agnieshka Baumritter; Alex R Kemper; Eleanor B Schron; Kelly Wade Journal: JAMA Ophthalmol Date: 2014-10 Impact factor: 7.389
Authors: Mark B Horton; Christopher J Brady; Jerry Cavallerano; Michael Abramoff; Gail Barker; Michael F Chiang; Charlene H Crockett; Seema Garg; Peter Karth; Yao Liu; Clark D Newman; Siddarth Rathi; Veeral Sheth; Paolo Silva; Kristen Stebbins; Ingrid Zimmer-Galler Journal: Telemed J E Health Date: 2020-03-25 Impact factor: 3.536