![the tiny balls of fat that could revolutionize medicine the tiny balls of fat that could revolutionize medicine](https://lh3.googleusercontent.com/-OPVHTeH7v1k/TI3kHJ19UGI/AAAAAAAAGBA/qWy0Iaz9Nmw/s512/PICT0848.jpg)
![the tiny balls of fat that could revolutionize medicine the tiny balls of fat that could revolutionize medicine](https://ic-cdn.flipboard.com/zdnet.com/aa8cf0d54bb9d031657b8e5db9d9cf56536a2049/_medium.jpeg)
![the tiny balls of fat that could revolutionize medicine the tiny balls of fat that could revolutionize medicine](https://pi.tedcdn.com/r/talkstar-photos.s3.amazonaws.com/uploads/1652d8dd-9901-4906-952a-869512fd06dd/KathrynAWhitehead_2021-embed.jpg)
“The results suggest that telemedicine could improve detection and treatment of ROP for millions of at-risk babies worldwide who lack immediate in-person access to an ophthalmologist,” she said.Ībout 450,000, or 12 percent, of the 3.9 million babies born each year in the United States are premature. “This is the first large clinical investigation of telemedicine to test the ability of non-physicians to recognize ROP at high risk of causing vision loss,” said Eleanor Schron, Ph.D., group leader of NEI Clinical Applications. Of these, non-physician image readers identified RW-ROP in all but three infants (98 percent). After referral, 162 infants were treated. The examining ophthalmologists documented 244 infants with RW-ROP on exam. And they were correct 87 percent of the time when presented with images from infants who lacked RW-ROP. Through the telemedicine approach, non-physician image readers correctly identified 90 percent of the infants deemed to have RW-ROP based on examination by an ophthalmologist. Trained non-physician image readers at the University of Pennsylvania, Philadelphia, then downloaded the photos, independently evaluated them following a standard protocol, and reported the presence or absence of RW-ROP. Either immediately before or after the exam, a non-physician staff member in the neonatal intensive care unit (NICU) took images of the infant’s retinas and uploaded them to a secure server at the University of Oklahoma, Oklahoma City. Those who were referred were designated as having referral-warranted ROP (RW-ROP). About every nine days, each infant underwent screening by an ophthalmologist, who assessed whether referral for treatment was warranted. The study evaluated telemedicine for ROP screening during the usual care of 1,257 premature infants who were born, on average, 13 weeks early. Early diagnosis and prompt treatment is the best prevention for vision loss from ROP, which is why the American Academy of Ophthalmology recommends routine screening for all babies who are born at gestational age 30 weeks or younger or who weigh less than 3.3 pounds at birth.
![the tiny balls of fat that could revolutionize medicine the tiny balls of fat that could revolutionize medicine](https://lh5.googleusercontent.com/-gdY83_e6foE/TI3ktZ0-pVI/AAAAAAAAGJI/iiqqgL_oc7U/s512/Karate%252520Pepi%252520Blumenau%252520SC%252520dandee.com.br%252520%25252832%252529.jpg)
Treatment involves destroying the abnormal blood vessels with lasers or freezing them using a technique called cryoablation. In ROP, blood vessels in the tissue in the back of the eye called the retina begin to grow abnormally, which can lead to scarring and detachment of the retina. Some degree of ROP appears in more than half of all infants born at 30 weeks pregnancy or younger-a full-term pregnancy is 40 weeks-but only about 5 to 8 percent of cases become severe enough to require treatment. In addition to UofL, study sites were Johns Hopkins University, Boston Children’s Hospital, Vanderbilt University, Children’s Hospital of Philadelphia, Nationwide Children’s Hospital/Ohio State University Hospital, Duke University, University of Minnesota, University of Oklahoma, University of Pennsylvania, University of Texas Health Science Center at San Antonio, University of Utah and Hospital of the Foothills Medical Center (Calgary, Canada). The University of Louisville was the only site in Kentucky among the collaborative group. The study was conducted by the e-ROP Cooperative Group, a collaboration that includes 12 facilities in the United States and one in Canada. Quinn, M.D., professor of ophthalmology at the Children's Hospital of Philadelphia and the lead investigator for the study, which is reported today in JAMA Ophthalmology. “This study provides validation for a telemedicine approach to ROP screening and could help save thousands of infants from going blind,” said Graham E. The study tested how accurately the telemedicine approach reproduced the conclusions of ophthalmologists who examined the babies onsite. Staff at the image reading center, who were trained to recognize signs of severe ROP, identified whether infants should be referred to an ophthalmologist for evaluation and potential treatment. The telemedicine strategy consisted of electronically sending photos of babies’ eyes to a distant image reading center for evaluation. NEI is a part of the National Institutes of Health. The investigators say that the approach, if adopted broadly, could help ease the strain on hospitals with limited access to ophthalmologists and lead to better care for infants in underserved areas of the country. Telemedicine is an effective strategy to screen for the potentially blinding disease known as retinopathy of prematurity (ROP), according to a study funded by the National Eye Institute (NEI).