Long-term visual outcomes of children screened for retinopathy of prematurity with telemedicine in Auckland, New Zealand

Abstract

Retinopathy of prematurity (ROP), a vasoproliferative disorder of the pre-term retina, is a preventable cause of childhood visual impairment. The Auckland Regional Telemedicine ROP (ART-ROP) network, established in 2006, utilises wide-field digital imaging and telemedicine to screen at-risk infants for ROP. This prospective observational study reports the long-term ophthalmic outcomes of infants screened by the ART-ROP network. Methods: A retrospective review of the ART-ROP network database from May 2008 to October 2011 identified 274 eligible children. All participants received a comprehensive paediatric ophthalmic examination including cycloplegic autorefraction and wide-field retinal imaging. Results: A total of 69 children, aged 5 to 8 years old were recruited and divided into two groups: with or without a history of ROP, 25 and 44 children respectively. Infants with ROP had significantly lower gestational age (26.6±1.9 vs. 29.1±1.6 weeks, p<0.001) and birth weight (937±237 vs. 1177±311 grams, p=0.001), with seven requiring treatment. No significant difference was detected between the two groups in visual acuity, Stereopsis, refractive error, or strabismus. Clinically significant refractive error was found in ten participants; none with moderate or high myopia. Retinal imaging exposed asymptomatic peripheral avascular retinal patches in four children, all whom had a history of regressed ROP. Conclusion: The ART-ROP network was effective in accurately diagnosing ROP. Visual outcomes did not vary based on children’s history of ROP, with no participant having reduced vision as a result of undetected or untreated ROP. Further research is required into the long-term implication of avascular retinal patches in regressed ROP. Presented at the 49th Annual Scientific Congress of The Royal Australian and New Zealand College of Ophthalmologists.