TeleROP-NI: Modernizing Retinopathy of Prematurity Screening in Northern Ireland to Enhance Decision-making and Ensure Sustainability

Abstract

Purpose: To present safety and effectiveness data on a real-world retinopathy of prematurity (ROP) telemedicine screening model in Northern Ireland and to evaluate a novel virtual multidisciplinary team (MDT) approach to ROP decision-making. Methods: Data were collected on all ROP screens performed in Northern Ireland between May 1, 2023, and October 31, 2023. A total of 431 screens (N = 127 infants) were undertaken: 250 by imagers only, 40 by both imagers and ophthalmologists using binocular indirect ophthalmoscopy, and 141 by ophthalmologists only. A survey of MDT members (n = 17) assessed the perceived value of the virtual MDT model. Results: Fifty-eight percent of screens were completed by ROP imagers, with 98.2% sensitivity in detecting any ROP, 100% sensitivity in detecting treatment-warranted ROP, and 100% specificity of determining absence of ROP. Ninety-eight percent of imaging screens were tolerated by infants. The MDT survey demonstrated favorable feedback, including how TeleROP-NI increases the likelihood of trainees undertaking ROP screening. Conclusions: This study confirms that the TeleROP-NI significantly reduced ophthalmologist workload and streamlined organizational barriers. Imaging of infants by nonclinicians is a safe and valuable practice, which allows an MDT approach to collective decision-making when treating patients in an area of medicine with serious clinical and medicolegal implications if disease is missed.