Saving precious sight

It’s among the happiest moments for new parents, when their baby makes eye contact and smiles in recognition. But for very premature babies, a common and potentially blinding eye disease can rob families of that moment.

More than half of all infants born 10 or more weeks prematurely have some level of retinopathy of prematurity, or ROP — a disease in which blood vessels in the back of the eye grow abnormally. That can lead to scarring and detachment of the retina. About 5 to 8 percent require treatment, which involves destroying the abnormal blood vessels with lasers or a freezing technique.

In the neonatal intensive care units at large hospitals such as University Hospital, these premature babies are screened regularly by a pediatric ophthalmologist for signs of ROP. But many hospitals across the country have limited access to these specially trained professionals. And in some less affluent parts of the world, rates of ROP-related blindness are as high as 30 percent.

“We don’t have enough specialists trained to do these exams, and most premature babies need an exam,” said Dr. Alice Gong, a neonatologist at University Health System, and professor of pediatrics at the UT Health Science Center. “This particular skill, to examine and treat these babies, is vanishing. A lot of ophthalmologists are not trained in this anymore.”

Gong was part of a national study to see if trained non-physicians working remotely could identify the disease from studying photos of the babies eyes. If potential cases were detected, they were referred to an ophthalmologist for evaluation and treatment.

The results, published in the journal JAMA Ophthalmology, found that that the method was effective, with the non-physician image readers correctly identifying 90 percent of infants with ROP needing treatment, and 87 percent of infants that didn’t need treatment. The study included 1,257 premature infants at 13 sites in the United States and Canada, including almost 80 babies at University Hospital.

“This study provides validation for a telemedicine approach to ROP screening and could help save thousands of infants from going blind,” said Dr. Graham E. Quinn, professor of ophthalmology at the Children’s Hospital of Philadelphia, who was the lead investigator for the entire study.