Reducing the Impact of the COVID-19 Pandemic on Retinopathy of Prematurity Screening: Successful Strategies Learnt from a Multi-Center Tele-Medicine Program in India

ABSTRACT

Purpose

Control of blindness due to retinopathy of prematurity (ROP) requires timely screening and treatment within 48–72 h. Anticipating that the coronavirus disease 2019 (COVID-19) pandemic would disrupt ROP services, we devised strategies '‘on-the'’-go”” to ameliorate this possiblity. We describe the successful outcomes of this approach in preventing infant blindness during the pandemic.

Methods

Data on the number of preemies recruited, screened and treated in the Karnataka Internet-assisted Diagnosis of Retinopathy of Prematurity (KIDROP) program were collected in a retrospective (2019, interval 1) – prospective (2020, interval 2) manner. We summarize 10 key strategies that were developed as we faced logistic, operational and implementation challenges. These included pragmatic methods of enhancing enrolment, transporting for screening and ensuring timely treatment in the outreach.

Results

The total number of ROP screening sessions was 20,598 (7,197 new) and 14,371 (5,773 new) during interval 1 and 2 respectively. Of these, 166 (2.3%) and 157 (2.7%) infants required treatment during interval 1 and 2 respectively. All infants needing treatment during the COVID period, were treated on time which was possible due to successful implementation of the ‘on-the-go’ strategies throughout the state of Karnataka. The fiscal equivalent of the blindness prevented during this period is USD 15.6 million.

Conclusion

The greater decline in the number of ROP screening episodes in neonatal units in government hospitals was because several were converted to ‘COVID only” hospitals. KIDROP’s multi-zonal, decentralized strategy, which uses non-physician-based imaging in a telemedicine network, ensured that essential ROP services continued even during the lockdown.

KEYWORDS:

• Analysis
• COVID-19
• hospitals
• Retinopathy of prematurity
• screening
• tele-medicine

Acknowledgments

KIDROP teams across the state that performed ROP screening throughout the study period.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Patient consent forms

Relevant patient consents were obtained for study/research purpose.

Authors Contribution

ANVI – conceptualising the study, data acquisition, analysing the data, statistics and results, interpreting the findings, writing & reviewing the manuscript

SM, RV – Analysing the data, statistics and results, interpreting the findings, writing & reviewing the manuscript

KBS, CJ, CG – critically reviewing the manuscript

Additional information

Funding

KIDROP provides ROP screening and treatment free of cost to babies born in Government (Public) hospitals.