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Study highlights need for improved, stable eye screening for premature babies

December 14, 2016

ANN ARBOR, Mich. - Among the challenges faced in caring for premature babies is protecting their eye sight, and concerns are growing about an available workforce ready to screen for retinopathy of prematurity.

Babies born early are at risk for ROP, a potentially blinding eye disorder.

A survey in Pediatrics, embargoed until 12:01 a.m. Dec. 14, shows only 56 percent of medical directors at 393 hospital neonatal intensive care units believe there are enough ophthalmologists who can screen and/or treat ROP in their local area.

Rebecca Vartanian, M.D., a neonatologist at the University of Michigan C.S. Mott Children's Hospital and colleagues at the U-M Kellogg Eye Center, learned 28 percent of NICUs do not provide ROP treatment, most often due to lack of ophthalmologists, and frequently transfer babies needing treatment to another hospital.

While increasing the number of well-trained eye care providers willing to screen and care for ROP would be ideal, study authors say there's an opportunity to build programs that allow babies to stay in their communities.

Currently in the U.S., babies weighing 1500 grams, about 3.3 pounds, or less that are born before 31 weeks are evaluated for ROP by an ophthalmologist in the NICU.

It's possible to screen for severe ROP by sending a retinal image taken in the NICU to an off-site reader. In the survey reported in Pediatrics, only 21 percent of respondents used retinal imaging devices and while some agreed it was safe (30 percent), half of the respondents were unsure.

Authors say the results represent a slow shift in perceptions about telemedicine.

In 2014, a multi-center clinical trial sponsored by the National Eye Institute showed telemedicine is effective and the approach could potentially give millions of premature babies worldwide greater access to ROP screening.

For the Pediatrics study, surveys were mailed to 847 level III NICUs, which are capable of caring for the smallest and sickest newborns. The NICUs were identified through the American Academy of Pediatrics 2015 directory. The response rate was 46 percent.
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University of Michigan Health System

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