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Telemedicine promises to save preemies’ sight at lower cost

Posted: Monday, July 14, 2014 · Volume: XLVII · Issue: 13

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Alice Gong, M.D., (right) consults with Javier and Angelica Perera about their baby, Santiago, at a recent doctor appointment.
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Alice Gong, M.D., (right) consults with Javier and Angelica Perera about their baby, Santiago, at a recent doctor appointment.clear graphic

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Contact: Elizabeth Allen, 210-450-2020

SAN ANTONIO (July 7, 2014) — A UT Kids neonatologist at University Hospital participated in a national study that confirmed a potentially blinding disease in premature babies could be identified safely and accurately from many miles away.

The study showed that telemedicine could effectively monitor vulnerable babies where pediatric ophthalmologists are in short supply — which is pretty much everywhere, said Alice Gong, M.D., professor in the School of Medicine at the UT Health Science Center San Antonio.

Significant need for specialty exams

“We don’t have enough specialists trained to do these exams, and most premature babies need an exam,” Dr. Gong said. “This particular skill, to examine and treat these babies, is vanishing. A lot of ophthalmologists are not trained in this anymore.”

Ophthalmology specialist Clio Armitage Harper III, M.D., (left)  is interviewed by Eileen Pace from Texas Public Radio regarding retinopathy of prematurity (ROP) screenings for premature babies.
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Ophthalmology specialist Clio Armitage Harper III, M.D., (left) is interviewed by Eileen Pace from Texas Public Radio regarding retinopathy of prematurity (ROP) screenings for premature babies. clear graphic

 

The problem is not just in rural areas. Even in San Antonio a retinal-trained ophthalmologist travels from Austin to work with the infants. Clio Armitage Harper III, M.D., an ophthalmology specialist at the Health Science Center, works with Dr. Gong on Tuesday afternoons to screen babies for the disease―retinopathy of prematurity (ROP)―common in the smallest and sickest premature babies.

Abnormal cell growth

In ROP, blood vessels in the tissue in the back of the eye begin to grow abnormally, which can lead to scarring and detachment of the retina. Treatment involves destroying undeveloped retinal tissue with a laser to decrease the signal from this tissue that forms abnormal blood vessel growth. Early diagnosis and prompt treatment is the best way to prevent permanent damage from ROP.

In the study funded by the National Eye Institute (NEI), images of babies’ eyes were electronically sent to an image reading center for evaluation. Staff there identified whether infants should be referred to an ophthalmologist, and the study compared their results to the conclusions of ophthalmologists who examined the babies in the hospitals.

The study found that non-physicians and physicians had similar success in assessing photos for ROP.

Remote exams more comfortable for babies and families

Dr. Gong said the idea is not only that babies can be diagnosed, but that if they could be followed remotely by these trained non-physicians as their condition progressed, they could stay in their neonatal intensive care unit close to their homes and be transferred to a referral hospital like University Hospital only at the time they need treatment.

“A lot of premature babies have ROP, but only about 10 percent need treatment,” Dr. Gong said. “With this technology we can make sure they get the treatment they need.”

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UT Kids San Antonio is the academic pediatric practice of the School of Medicine at the UT Health Science Center at San Antonio. With almost 100 pediatric physicians and surgeons – all faculty members of the Health Science Center’s School of Medicine – UT Kids™ San Antonio is the largest pediatric practice in Central and South Texas offering top-tier expertise in numerous medical specialties and subspecialties. Most major health plans are accepted. To find the pediatric specialist you need, visit UTKids.org.

 
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