title: Role of tele-medicine in retinopathy of prematurity screening in rural outreach centers in India - a report of 20,214 imaging sessions in the KIDROP program.
abstract: Middle-income countries such as India are suffering from the third epidemic of retinopathy of prematurity (ROP). Improved survival and lower infant mortality rates have resulted in an increased number of preterm survivors in rural areas that unfortunately lack ROP specialists. We report our experience of a public-private partnership in rural India of an ongoing telemedicine program Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity program KIDROP that provides ROP screening by non-physicians. The analysis of 20,214 imaging sessions of 7106 from 36 rural centers in 77 months of activity are presented. The overall incidence of any stage and treatment requiring ROP was 22.39% and 3.57% respectively. We found a higher incidence of severe ROP in private (7.1%) vs government centers (1.7%). Fifty of the 254 babies (19.69%) who underwent treatment were outside the American screening guidelines cut-off. The report compares other "real-world" tele-ROP programs, summarizes the impact, and provides future strategies for outreach ROP screening in middle-income countries.
authors.affiliation: Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, India. Electronic address: anandvinekar@yahoo.com.
authors.forename: Anand
authors.initials: A
authors.lastname: Vinekar
authors.affiliation: Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, India.
authors.forename: Chaitra
authors.initials: C
authors.lastname: Jayadev
authors.affiliation: Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, India; Duke University, Durham, NC, USA.
authors.forename: Shwetha
authors.initials: S
authors.lastname: Mangalesh
authors.affiliation: Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, India.
authors.forename: Bhujang
authors.initials: B
authors.lastname: Shetty
authors.affiliation: University of Illinois, Chicago, IL, USA; M.S. Ramaiah Medical College, Bangalore, India.
authors.forename: Dharmapuri
authors.initials: D
authors.lastname: Vidyasagar
mesh_terms: D006801:Humans; D015994:Incidence; D007194:India; D007231:Infant, Newborn; D015997:Neonatal Screening; D015397:Program Evaluation; D055818:Public-Private Sector Partnerships; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D019035:Rural Health Services; D017216:Telemedicine
keywords: India; Laser; Outreach; Retinopathy of prematurity; Rural; Screening; Telemedicine