In Reply We thank Vinekar and colleagues for their comments on our project and also for providing more details about KIDROP, which represents an important addition to the effort to provide ROP detection for premature infants. One point that needs to be made in response about our study is that the primary purpose of the e-ROP Study was to determine the validity of the remote evaluation of images for ROP and not the timeliness of feedback to the neonatal care unit. In contrast to the KIDROP approach, all e-ROP Study infants underwent diagnostic examinations and received routine clinical care by an ROP-experienced ophthalmologist. Because the e-ROP Study was designed to grade all images from the infants with referral-warranted ROP and only image sets from a sample of the infants who did not develop referral-warranted ROP, all images from an infant needed to be available before the decision whether to put those images in the reading queue was made. Therefore, we could not determine the rapidity of turnaround in the primary study. We do agree that it is important to determine the timeliness of image grading turnaround now that the e-ROP Study has established the validity of remote image grading. Thus, we are undertaking an implementation study to determine whether turnaround within 24 hours can be accomplished using a reading center.
Quinn GE, for the e-ROP Cooperative Group. Need for Telemedicine in Retinopathy of Prematurity in Middle-Income Countries—Reply. JAMA Ophthalmol. 2015;133(3):361-362. doi:10.1001/jamaophthalmol.2014.4921