To improve time-critical sight screening for premature babies at risk of retinopathy of prematurity (ROP), Addenbrooke’s Hospital’s Eye Department has introduced a new telemedicine service. Led by its Consultant Paediatric Ophthalmologist Louise Allen, the service uses an innovative approach to assessing ROP using the Vantage digital indirect ophthalmoscope from Keeler.
ROP affects around 70% of very early, low birthweight babies and can lead to blindness if not treated promptly with laser surgery. Until now, any babies screened in Eastern neonatal network units and suspected of having severe ROP warranting treatment had to be transferred to Addenbrooke’s for a second opinion. This often involved a long journey across the region in a neonatal ambulance.
“Addenbrooke‘s is the established treatment centre for ROP in the Eastern network,” Louise explained. “That used to mean that any at-risk babies in the region were immediately transferred to us – sometimes over long distances – so we could examine them in person. This was obviously stressful and disruptive for the baby and his/her parents, and it created a significant knock-on effect in the ward, requiring other babies to be moved to other units in the region to free up cot space for the transfer. Also, if I found that the baby’s ROP was not severe enough to treat at that time, he/she would be returned to the original unit, possibly to make the trip again a week or so later for review. It therefore made sense to adopt a new approach.”
This new approach involves seven Vantage indirect ophthalmoscopes being delivered to hospitals throughout the Eastern region. The Vantage allows the capture of digital images which can then be sent anywhere in the world for examination – known as telemedicine. This may transform the way ROP is managed in the UK.
“The joy of telemedicine using an indirect ophthalmoscope is that you can send a high-quality digital image remotely and can get an immediate second opinion without having to physically send the baby,” added Louise. “This means we can eliminate unnecessary transfers and keep the neonatal intensive care cots here free for babies in need. Additionally, the digital indirect ophthalmoscope is more cost effective than other photographic methods and can also be used for training our future screeners. ”
The telemedicine project could not have been possible without support from Addenbrooke’s Charitable Trust (ACT). “The trust was delighted to fund the ROP project so that patients from neighbouring hospitals can benefit from the expertise that Addenbrooke’s has to offer,” commented the ACT’s Chief Executive, Stephen Davies.
Commenting on the project, Keeler’s Research and Development Director, Adrian Beasley, said, “As an engineer there is nothing more rewarding than working on technology that has real human impact. It’s therefore a real privilege to work alongside Louise and the professional team at Addenbrooke’s. I have no doubt that the project will save sight and deliver cost savings for Addenbrooke’s and the Eastern region.”