Publication: Retinopatía del prematuro mediante el análisis de retinografías: disparidad en el diagnóstico según el tipo de experto en visión
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2015-05-19
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Universidad Complutense de Madrid
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Abstract
Actualmente, la Retinopatía del Prematuro (ROP) es una de las principales causas de ceguera infantil potencialmente evitable. Se define como una retinopatía vasoproliferativa periférica que afecta a recién nacidos inmaduros, generalmente sometidos a oxigenoterapia y de etiopatogenia actualmente desconocida. El incremento de sobrevida de recién nacidos cada vez más prematuros hace de esta enfermedad un problema de Salud Pública. La mayoría de los casos evoluciona favorablemente, sin embargo un pequeño porcentaje puede dejar secuelas leves como miopía o graves como ceguera. El objetivo principal del estudio es identificar al profesional sanitario experto en visión cualificado para controlar la ROP mediante el análisis de retinografías utilizando la Telemedicina. Actualmente, la oftalmoscopía binocular indirecta (OBI) es el método de referencia para la detección de ROP sin embargo, los inconvenientes de esta prueba son múltiples. La exploración con OBI es un método complicado que requiere un oftalmólogo especializado en prematuros, las interpretaciones del examinador son transcritas a hojas de exploración donde el diagnóstico se presume correcto, sin posibilidad de revisión. Los avances en oftalmología permiten realizar los registros mediante la cámara RetCam3, diseñada para capturar retinografías en prematuros. Así se solventan varios problemas del método convencional de diagnóstico. En muchos hospitales de diversas comunidades, la exploración de los prematuros es difícil debido al aumento de niños que requieren seguimiento y la escasez del personal cualificado que puede realizar la prueba. Con la RetCam3 se pueden capturar retinografías de los prematuros y enviarlas al especialista en ROP para su telediagnóstico. De esta manera, se elimina el traslado del niño y se evita el riesgo que esto supone para su delicado estado de salud. Se identifican a los oftalmólogos especialistas en ROP como el único profesional sanitario experto en visión capacitado para diagnosticar y controlar la ROP mediante el análisis de retinografías utilizando la Telemedicina.
Currently, retinopathy of prematurity (ROP) is one of the leading causes of infant blindness that is potentially avoidable. It is defined as a peripheral vasoproliferative retinopathy, presently of unknown etiopathogenesis, that affects immature newborns, generally on oxygen therapy. Survival rate of newborns increasingly premature converts this disorder into a public health problem. The majority of cases evolve favorably; however, a small percentage can progress and leave sequela, which can be mild, such as myopia, or severe, such as a blindness. The main objective of this study is to identify the vision expert health professional best qualified to control retinopathy of prematurity by analysis of retinography imaging at the Telemedicine service. At present, reference method for ROP detection is binocular indirect ophthalmoscopy (BIO). However, this technique offers multiple disadvantages. BIO examination requires execution by an ophthalmologist expert in pediatric retina, examiner interpretations are transcript to examination documents, were diagnosis is presumed correct, as revision is impossible. In ophthalmology, advanced technology currently enables the use of the proposed diagnostic procedure: the use of a wide-angle camera RetCam3, designed to capture high quality images in premature infants, thus solving some of the problems related to the conventional diagnosis method. Premature exploration is difficult in many hospitals located in some small communities or rural areas, as there is an increasing number of infants that require ROP-follow up and the number of qualified personnel is scarce. However, RetCam3 enables premature retinal image capture and its delivery to an ROP-expert for telediagnosis. This removes the need for infant’s transportation to specialist’s location, thus avoiding related risks due to its delicate health condition. ROP-expert ophthalmologists are identified as the sole vision expert health professional qualified for ROP diagnosis and control by retinography analysis through a Telemedicine service.
Currently, retinopathy of prematurity (ROP) is one of the leading causes of infant blindness that is potentially avoidable. It is defined as a peripheral vasoproliferative retinopathy, presently of unknown etiopathogenesis, that affects immature newborns, generally on oxygen therapy. Survival rate of newborns increasingly premature converts this disorder into a public health problem. The majority of cases evolve favorably; however, a small percentage can progress and leave sequela, which can be mild, such as myopia, or severe, such as a blindness. The main objective of this study is to identify the vision expert health professional best qualified to control retinopathy of prematurity by analysis of retinography imaging at the Telemedicine service. At present, reference method for ROP detection is binocular indirect ophthalmoscopy (BIO). However, this technique offers multiple disadvantages. BIO examination requires execution by an ophthalmologist expert in pediatric retina, examiner interpretations are transcript to examination documents, were diagnosis is presumed correct, as revision is impossible. In ophthalmology, advanced technology currently enables the use of the proposed diagnostic procedure: the use of a wide-angle camera RetCam3, designed to capture high quality images in premature infants, thus solving some of the problems related to the conventional diagnosis method. Premature exploration is difficult in many hospitals located in some small communities or rural areas, as there is an increasing number of infants that require ROP-follow up and the number of qualified personnel is scarce. However, RetCam3 enables premature retinal image capture and its delivery to an ROP-expert for telediagnosis. This removes the need for infant’s transportation to specialist’s location, thus avoiding related risks due to its delicate health condition. ROP-expert ophthalmologists are identified as the sole vision expert health professional qualified for ROP diagnosis and control by retinography analysis through a Telemedicine service.
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Óptica y Optometría, leída el 22-07-2014