Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): five years of screening with telemedicine

Ophthalmic Surg Lasers Imaging Retina. 2014 Mar-Apr;45(2):106-13. doi: 10.3928/23258160-20140122-01. Epub 2014 Jan 20.


Background and objective: To report the 5-year results of the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) telemedicine initiative.

Patients and methods: Infants requiring retinopathy of prematurity (ROP) screening at six neonatal intensive care units from December 1, 2005, to November 30, 2010, were evaluated with remote retinal photography by an ROP specialist. Every infant received outpatient binocular indirect ophthalmoscope examinations until termination criteria were achieved or until treatment. Outcomes were treatment-warranted ROP (TW-ROP, ETROP type 1) and adverse anatomical events.

Results: Five hundred eleven infants (1,022 eyes) were screened. Fifteen infants had TW-ROP and underwent laser photocoagulation. The TW-ROP cohort had significantly lower birth weight and gestational age (both P < .001). No patient progressed to adverse anatomical outcomes and no case of TW-ROP was missed. Tele-medicine had 100% sensitivity, 99.8% specificity, 93.8% positive predictive value, and 100% negative predictive value for detection of TW-ROP.

Conclusion: Telemedicine demonstrates high diagnostic accuracy for detection of TW-ROP and can complement ROP screening.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Academic Medical Centers / organization & administration
  • Birth Weight
  • California
  • Community Networks / organization & administration
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Laser Coagulation
  • Male
  • Neonatal Screening / methods*
  • Ophthalmoscopy
  • Photography
  • Reproducibility of Results
  • Retinopathy of Prematurity / diagnosis*
  • Retinopathy of Prematurity / surgery
  • Sensitivity and Specificity
  • Telemedicine / methods*
  • Vision Screening / methods*