Telemedicina en retinopatía del prematuro: Atravesando fronteras en la salud visual pediátrica. Estudio TELEROP / Telemedicine in retinopathy of prematurity: Crossing borders in pediatric vision health. TELEROP study

Objetivo general Evaluar la precisión y validez de imágenes vía teléfono inteligente en comparación con el sistema RetCam® para el diagnóstico de retinopatía del prematuro (ROP). Metodología Estudio observacional, de corte longitudinal y enmascarado realizado en el hospital Dr. Elías Santana. Se incluyeron infantes con peso al nacer ≤ 1.500 g, edad gestacional ≤ 30 semanas y/o pacientes expuestos a factores de riesgo o complicaciones ligadas a ROP. Estos sujetos fueron tamizados empleando imágenes vía teléfono inteligente o RetCam®, ambos comparados con la fondoscopía convencional. Se utilizó la clasificación de ICROP para la estadificación. Los resultados principales analizados fueron sensibilidad, especificidad, valores predictivos e índice kappa. Resultados Se obtuvieron 915 imágenes (n = 121), distribuidas en grupo teléfono inteligente (50,4%) y grupo RetCam® (49,6%) entre agosto del 2020 y marzo del 2021. Los sujetos que presentaron ROP tuvieron menor edad gestacional (30,2 sem ± 2.8), peso al nacer (1.361 g ± 398) y mayor exposición a oxigenoterapia (12,8 días ± 11,3). El grupo RetCam® presentó sensibilidad = 80%, especificidad = 78%, valor predictivo positivo = 90% e índice kappa = 0,70. El grupo teléfono inteligente presentó sensibilidad = 88%, especificidad = 90%, valor predictivo positivo = 93,75% e índice kappa = 0,81. Conclusiones Ambos métodos diagnósticos fueron precisos para identificar ROP. El grupo teléfono inteligente obtuvo resultados superiores con una excelente resolución, representando un método costo-efectivo para crear un impacto global en la reducción de la ceguera prevenible en población pediátrica (AU)

General objective To evaluate the accuracy and validity of images with smartphone compared to the RetCam® system for the diagnosis of retinopathy of prematurity (ROP). Methodology Observational, longitudinal and masked study carried out at the Dr. Elías Santana hospital. Infants with birth weight ≤ 1500 g, gestational age ≤ 30 weeks and/or patients exposed to risk factors or complications linked to ROP were included. These subjects were screened using images with smartphone or RetCam®, both compared to conventional fundoscopy. The ICROP classification was used for staging. The main results analyzed were sensitivity, specificity, positive predictive values and kappa index. Results 915 images (n = 121) were obtained, distributed in smartphone group (50.4%) and RetCam® group (49.6%) between August 2020 and March 2021. Subjects with ROP had lower gestational age (30.2 sem ± 2.8), birth weight (1361 g ± 398), and greater exposure to oxygen therapy (12.8 days ± 11.3). The RetCam® group presented sensitivity = 80%, specificity = 78%, positive predictive value = 90% and kappa index = 0.70. The smartphone group presented sensitivity = 88%, specificity = 90%, positive predictive value = 93.75% and kappa index = 0.81. Conclusions Both diagnostic methods were accurate to identify ROP. The smartphone group obtained superior results with excellent resolution, representing a cost-effective method to create a global impact on reducing preventable blindness in the pediatric population (AU)

Telemedicine in retinopathy of prematurity: Crossing borders in pediatric vision health. TELEROP study.

GENERAL OBJECTIVE: To evaluate the accuracy and validity of images with smartphone compared to the RetCam® system for the diagnosis of retinopathy of prematurity (ROP). METHODOLOGY: Observational, longitudinal and masked study carried out at the Dr. Elías Santana hospital. Infants with birth weight ≤1500 g, gestational age ≤30 weeks and/or patients exposed to risk factors or complications linked to ROP were included. These subjects were screened using images with smartphone or RetCam®, both compared to conventional fundoscopy. The ICROP classification was used for staging. The main results analyzed were sensitivity, specificity, positive predictive values and kappa index. RESULTS: 915 images (n = 121) were obtained, distributed in smartphone group (50.4%) and RetCam® group (49.6%) between August 2020 and March 2021. Subjects with ROP had lower gestational age (30.2 sem ± 2.8), birth weight (1361 g ± 398), and greater exposure to oxygen therapy (12.8 days ± 11.3). The RetCam® group presented sensitivity = 80%, specificity = 78%, positive predictive value = 90% and kappa index = 0.70. The smartphone group presented sensitivity = 88%, specificity = 90%, positive predictive value = 93.75% and kappa index = 0.81. CONCLUSIONS: Both diagnostic methods were accurate to identify ROP. The smartphone group obtained superior results with excellent resolution, representing a cost-effective method to create a global impact on reducing preventable blindness in the pediatric population.