Internet-based versus Conventional Referral System for Retinopathy of Prematurity Screening in Iran.
To compare the efficacy of an internet-based versus traditional referral system for retinopathy of prematurity (ROP) screening in Iran.



Two referral screening systems were compared in this prospective observational study. Group A (internet-based) comprised premature babies who were registered into an online system for screening. Their appointments were scheduled automatically based on standardized criteria. Group B (conventional) comprised premature babies whose referrals were based on oral or written recommendations. Babies were referred based on standard criteria (gestational age, GA, <37 weeks or birth weight < 3000 g).



A total of 2115 neonates were screened between October 2011 and October 2012. From these 1896 met the inclusion criteria (group A n = 856, group B n = 1040). Time of first examination for neonates with GA≤27 weeks was 30.07± 2.72 weeks postmenstrual age in group A and 38.52± 7.03 weeks in group B (p = 0.049), and for neonates with GA>27 weeks was 4.86 ±1.77 and 8.16 ±4.93 weeks after birth in groups A and B, respectively (p < 0.001). All registered babies in group A attended their first screening exam. One case (0.1%) of advanced ROP developed in group A (in a patient with poor follow-up compliance), whereas advanced stages of ROP were seen in 26 cases (2.5%) in group B (p < 0.001).



An internet-based registration system for ROP screening resulted in fewer cases of delayed first examination and resulted in fewer babies with advanced ROP.
a Retina Service, Department of Ophthalmology , Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston , MA, USA.
Nazanin
N
Ebrahimiadib
b Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
Ramak
R
Roohipour
b Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
Reza
R
Karkhaneh
b Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
Afsar
A
Farahani
b Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
Mohammad Riazi
MR
Esfahani
b Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
Alireza
A
Khodabande
b Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
Mohammad
M
Zarei
b Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
Arash
A
Taheri
b Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
Marjan Imani
MI
Fouladi
c Department of Epidemiology and Biostatistics , Tehran University of Medical Sciences , Tehran , Iran.
Mehdi
M
Yaseri
a Retina Service, Department of Ophthalmology , Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston , MA, USA.
Bobeck S
BS
Modjtahedi
D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D020407:Internet; D007492:Iran; D008297:Male; D015997:Neonatal Screening / Q000379:methods / Q000458:organization & administration*; D011446:Prospective Studies; D012017:Referral and Consultation / Q000458:organization & administration*; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D015351:Vision Screening / Q000458:organization & administration*
Internet-based; Iran; referral; retinopathy of prematurity; screening