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Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems

PURPOSE: Neonatal care in middle-income countries has improved over the last decade, leading to a “third epidemic” of retinopathy of prematurity (ROP). Without concomitant improvements in ROP screening infrastructure, reduction of ROP-associated visual loss remains a challenge worldwide. The emergen...

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Autores principales: Tan, Zachary, Isaacs, Michael, Zhu, Zhuoting, Simkin, Samantha, He, Mingguang, Dai, Shuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583350/
https://www.ncbi.nlm.nih.gov/pubmed/36276257
http://dx.doi.org/10.4103/sjopt.sjopt_220_21
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author Tan, Zachary
Isaacs, Michael
Zhu, Zhuoting
Simkin, Samantha
He, Mingguang
Dai, Shuan
author_facet Tan, Zachary
Isaacs, Michael
Zhu, Zhuoting
Simkin, Samantha
He, Mingguang
Dai, Shuan
author_sort Tan, Zachary
collection PubMed
description PURPOSE: Neonatal care in middle-income countries has improved over the last decade, leading to a “third epidemic” of retinopathy of prematurity (ROP). Without concomitant improvements in ROP screening infrastructure, reduction of ROP-associated visual loss remains a challenge worldwide. The emergence of teleophthalmology screening programs and artificial intelligence (AI) technologies represents promising methods to address this growing unmet demand in ROP screening. An improved understanding of current ROP screening programs may inform the adoption of these novel technologies in ROP care. METHODS: A critical narrative review of the literature was carried out. Publications that were representative of established or emerging ROP screening programs in high-, middle-, and low-income countries were selected for review. Screening programs were reviewed for inclusion criteria, screening frequency and duration, modality, and published sensitivity and specificity. RESULTS: Screening inclusion criteria, including age and birth weight cutoffs, showed significant heterogeneity globally. Countries of similar income tend to have similar criteria. Three primary screening modalities including binocular indirect ophthalmoscopy (BIO), wide-field digital retinal imaging (WFDRI), and teleophthalmology were identified and reviewed. BIO has documented limitations in reduced interoperator agreement, scalability, and geographical access barriers, which are mitigated in part by WFDRI. Teleophthalmology screening may address limitations in ROP screening workforce distribution and training. Opportunities for AI technologies were identified in the context of these limitations, including interoperator reliability and possibilities for point-of-care diagnosis. CONCLUSION: Limitations in the current ROP screening include scalability, geographical access, and high screening burden with low treatment yield. These may be addressable through increased adoption of teleophthalmology and AI technologies. As the global incidence of ROP continues to increase, implementation of these novel modalities requires greater consideration.
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spelling pubmed-95833502022-10-21 Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems Tan, Zachary Isaacs, Michael Zhu, Zhuoting Simkin, Samantha He, Mingguang Dai, Shuan Saudi J Ophthalmol Original Article PURPOSE: Neonatal care in middle-income countries has improved over the last decade, leading to a “third epidemic” of retinopathy of prematurity (ROP). Without concomitant improvements in ROP screening infrastructure, reduction of ROP-associated visual loss remains a challenge worldwide. The emergence of teleophthalmology screening programs and artificial intelligence (AI) technologies represents promising methods to address this growing unmet demand in ROP screening. An improved understanding of current ROP screening programs may inform the adoption of these novel technologies in ROP care. METHODS: A critical narrative review of the literature was carried out. Publications that were representative of established or emerging ROP screening programs in high-, middle-, and low-income countries were selected for review. Screening programs were reviewed for inclusion criteria, screening frequency and duration, modality, and published sensitivity and specificity. RESULTS: Screening inclusion criteria, including age and birth weight cutoffs, showed significant heterogeneity globally. Countries of similar income tend to have similar criteria. Three primary screening modalities including binocular indirect ophthalmoscopy (BIO), wide-field digital retinal imaging (WFDRI), and teleophthalmology were identified and reviewed. BIO has documented limitations in reduced interoperator agreement, scalability, and geographical access barriers, which are mitigated in part by WFDRI. Teleophthalmology screening may address limitations in ROP screening workforce distribution and training. Opportunities for AI technologies were identified in the context of these limitations, including interoperator reliability and possibilities for point-of-care diagnosis. CONCLUSION: Limitations in the current ROP screening include scalability, geographical access, and high screening burden with low treatment yield. These may be addressable through increased adoption of teleophthalmology and AI technologies. As the global incidence of ROP continues to increase, implementation of these novel modalities requires greater consideration. Wolters Kluwer - Medknow 2022-10-14 /pmc/articles/PMC9583350/ /pubmed/36276257 http://dx.doi.org/10.4103/sjopt.sjopt_220_21 Text en Copyright: © 2022 Saudi Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Tan, Zachary
Isaacs, Michael
Zhu, Zhuoting
Simkin, Samantha
He, Mingguang
Dai, Shuan
Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems
title Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems
title_full Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems
title_fullStr Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems
title_full_unstemmed Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems
title_short Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems
title_sort retinopathy of prematurity screening: a narrative review of current programs, teleophthalmology, and diagnostic support systems
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9583350/
https://www.ncbi.nlm.nih.gov/pubmed/36276257
http://dx.doi.org/10.4103/sjopt.sjopt_220_21
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