Ophthalmology. Retina · 2026
Telemedicine Utilization for Retinopathy of Prematurity Screening in Premature Infants: Systematic Review and Meta-Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Pandiri Srujay, Chaaya Celine, Brant Arthur, Hoyek Sandra, Bejjani Romy, Malek Davina A, Zhao Yan, Baldwin Grace, Awh Caroline, Patel Nimesh A
Аннотация
TOPIC: The purpose of this study was to report the sensitivities and specificities of telemedicine technology used to screen for referral-warranted (RW)-retinopathy of prematurity (ROP) and treatment-required (TR)-ROP.
CLINICAL RELEVANCE: Retinopathy of prematurity is a leading cause of blindness in premature infants. Tele-ROP has emerged as a novel method to help screen for ROP in low-resource locations and showcases significant promise.
METHODS: PubMed, Embase, and Web of Science databases were searched from January 2000 to October 2024. Studies reporting sensitivities and specificities of RW-ROP or TR-ROP were included in the meta-analysis. These values were combined using random-effects meta-analysis. Risk of bias was determined via the Newcastle Ottawa Scale and Quality Assessment of Diagnostic Accuracy Studies-2 tool. The study protocol was registered and published on the International Prospective Register of Systematic Reviews (CRD42024608378).
RESULTS: Of 905 identified studies, 16 studies met the inclusion criteria and were thus included in the meta-analysis. Of 3527 patients, 6149 eyes were studied. The sensitivity in the RW group was 0.93 (95% CI, 0.83-0.98), with low heterogeneity between studies (I2 = 0.0%; P = 0.75), and the overall specificity was 0.95 (95% CI, 0.85-0.98), with heterogeneity between studies (I2 = 91.2%; P < 0.001). Certainty of evidence was graded as moderate for sensitivity and high for specificity using the GRADE approach. Regarding the TR-ROP group, the sensitivity was 0.97 (95% CI, 0.92-0.99), with low heterogeneity between studies (I2 = 0.0%; P = 0.97), and the specificity was 0.97 (95% CI, 0.91-0.99), with heterogeneity between studies (I2 = 88.2%; P < 0.001). Certainty of evidence was graded as high. Post-2010 studies had greater sensitivities and specificities for RW-ROP: P < 0.001 and P = 0.77, respectively. Treatment-required -ROP sensitivity and specificity were higher in studies conducted after 2010 than prior: P = 0.06 and P < 0.001, respectively. Sensitivity and specificity for US vs. non-US-based studies were (0.83 vs. 0.92, P = 0.012) and (0.97 vs. 0.88, P = 0.04), respectively. Specificity for TR-ROP between US vs. non-US-based studies was 0.98 vs. 0.95, P < 0.001, respectively.
CONCLUSION: Remote digital fundus imaging may be an option for ROP screening, particularly in low-resource areas. There was significant variability. This suggests a need for continued formal training for both photographers and graders.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
CLINICAL RELEVANCE: Retinopathy of prematurity is a leading cause of blindness in premature infants. Tele-ROP has emerged as a novel method to help screen for ROP in low-resource locations and showcases significant promise.
METHODS: PubMed, Embase, and Web of Science databases were searched from January 2000 to October 2024. Studies reporting sensitivities and specificities of RW-ROP or TR-ROP were included in the meta-analysis. These values were combined using random-effects meta-analysis. Risk of bias was determined via the Newcastle Ottawa Scale and Quality Assessment of Diagnostic Accuracy Studies-2 tool. The study protocol was registered and published on the International Prospective Register of Systematic Reviews (CRD42024608378).
RESULTS: Of 905 identified studies, 16 studies met the inclusion criteria and were thus included in the meta-analysis. Of 3527 patients, 6149 eyes were studied. The sensitivity in the RW group was 0.93 (95% CI, 0.83-0.98), with low heterogeneity between studies (I2 = 0.0%; P = 0.75), and the overall specificity was 0.95 (95% CI, 0.85-0.98), with heterogeneity between studies (I2 = 91.2%; P < 0.001). Certainty of evidence was graded as moderate for sensitivity and high for specificity using the GRADE approach. Regarding the TR-ROP group, the sensitivity was 0.97 (95% CI, 0.92-0.99), with low heterogeneity between studies (I2 = 0.0%; P = 0.97), and the specificity was 0.97 (95% CI, 0.91-0.99), with heterogeneity between studies (I2 = 88.2%; P < 0.001). Certainty of evidence was graded as high. Post-2010 studies had greater sensitivities and specificities for RW-ROP: P < 0.001 and P = 0.77, respectively. Treatment-required -ROP sensitivity and specificity were higher in studies conducted after 2010 than prior: P = 0.06 and P < 0.001, respectively. Sensitivity and specificity for US vs. non-US-based studies were (0.83 vs. 0.92, P = 0.012) and (0.97 vs. 0.88, P = 0.04), respectively. Specificity for TR-ROP between US vs. non-US-based studies was 0.98 vs. 0.95, P < 0.001, respectively.
CONCLUSION: Remote digital fundus imaging may be an option for ROP screening, particularly in low-resource areas. There was significant variability. This suggests a need for continued formal training for both photographers and graders.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.