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Invited Commentary
May 2018

Ophthalmoscopy and Telemedicine in Retinopathy of Prematurity

Author Affiliations
  • 1Department of Ophthalmology, University of Pennsylvania, Philadelphia
JAMA Ophthalmol. 2018;136(5):505-506. doi:10.1001/jamaophthalmol.2018.0656

Amid the gloom created by a surplus of articles on the variability that appears to be intrinsic to the clinical diagnosis of severe retinopathy of prematurity (ROP), telemedicine brings a modicum of cheer. There are advantages and disadvantages to both methods: ophthalmoscopy is performed in real time, with the examiner having the flexibility of focusing on pathologic characteristics. Binocular examination gives a perception of depth and zone III can be visualized. However, the examining ophthalmologist has a limited amount of time to gather and retain material for documentation while examining an often distressed and struggling infant who is attached to various pieces of life-sustaining equipment in the neonatal intensive care unit, with watchful anxious parents. Images captured in telemedicine are instantaneous and lasting documentation that can be examined at a remote reading center in a well-controlled laboratory-like environment. These images also allow for computerized algorithmic evaluations. Nevertheless, taking well-focused, complete, and clear images in surroundings similar to that of diagnostic examinations is not an easy task.