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- Title
Telemedicina: alternativa en tamizaje y detección de retinopatía del prematuro en México.
- Authors
Zepeda-Romero, Luz Consuelo; Razo-Cervantes, Juan Carlos; Aguilar-Rodríguez, Fernando; Barragán-Sánchez, Andrea; Angulo-Castellanos, Eusebio; Pérez-Rulfo-Ibarra, Daniel; Padilla-Muñoz, Horacio; González-Bernal, Cesareo; Márquez-González, Rosa María; Gutiérrez-Chávez, Diego Alfonso; Gutiérrez-González, Alejandro; Haro-Cruz, Jorge Said; Gallego-Tapia, Ana Raquel; López-Romero, Jorge Alberto; Guerrero-Reyna, Anahí Gabriela; Mercado-Cerda, Jennefer Iveth; Valenzuela-González, Lorena; Martínez-Guerrero, Juan Raúl; Fernández-Estrada, Lythaí Florencia; Orozco-Covarrubias, Víctor Horacio
- Abstract
Introduction. Due to the constant increase in the survival of premature newborns, as well as the insufficient number of ophthalmologists capacitated for early detection amongst Neonatal Intensive Care Units, retinopathy of prematurity has become the number one cause of childhood blindness in our country. In other countries, the use of telemedicine has demonstrated to be a useful tool in capable hands, allowing for high sensibility and specificity on case detection. Methods. We conducted a descriptive study, in which the Neonatal Intensive Care Units of 3 hospitals were visited. In one of them, the weekly visits lasted a month, in the other two, they lasted 3 months. We proceeded to identify and register all premature newborns with the risk of prematurity retinopathy according to previously defined criteria, afterward, digital images of their eyes were taken with the RetCam Shuttle. The images were then sent to an ophthalmologist for their remote interpretation. Infants with a high degree of suspicion of type 1 retinopathy were sent to a specialized center for appropriate treatment when the diagnosis was confirmed, the rest received follow-up until meeting discharge criteria. Results. A total of 215 remote evaluations were conducted in 88 preterm infants during the study period. Of these patients, 47% (n=41) showed some degree of retinopathy, and 18% (n=16) required laser photocoagulation. All of those who underwent surgical intervention presented an adequate postoperative evolution. Those who did not require surgery had a favorable evolution, being discharged without complications. Amongst those with retinopathy, the average weight was 1255 grams, in contrast with the non-retinopathy group, where it was 1571 grams (p=0.0010). Retinopathy was detected in the first visit in 59% (n=24) of cases. Supplementary oxygen was required in 49% (n=43) of the cases, with 74% (n=32) of these presenting some degree of retinopathy. Discussion. The use of telemedicine for the detection of retinopathy of prematurity in Neonatal Intensive Care Units with limited resources proved itself to be a useful method of long-distance diagnosis, allowing for the identification of newborns who require immediate intervention. At the same time, it allows for a long-distance follow-up of those infants with less severe cases, diminishing the need for mobilization, as well as the risks of it.
- Subjects
INTENSIVE care units; RETROLENTAL fibroplasia; NEONATAL intensive care; PREMATURE infants; DIGITAL images; LASER photocoagulation
- Publication
Revista Médica MD, 2019, Vol 11, Issue 2, p81
- ISSN
2007-8188
- Publication type
Article