Monitoring the Evolution of Stage IV-A Retinopathy of Prematurity Using Retinal Imaging: A Case Series

Amidst the growing Retinopathy of Prematurity (RoP) crisis in India, tele-screening has assumed an important role, enabling RoP practitioners to screen a large number of babies without the need to travel everywhere. Though Binocular Indirect Ophthalmoscopic (BIO) examination is the current gold-standard for RoP screening, RoP drawings have not been scientifically evaluated for accuracy. There is significant inter-observer variability in this method of documentation. Digital fundus imaging is reproducible, quick and additionally can help to detect minute changes in the disease state which are not so obvious on Indirect Ophthalmoscopy examination. Digital Fundus Imaging can also help in parent counselling and medicolegal documentation. We present three cases of peri-papillary volcano-type tractional retinal detachment which were serially monitored using fundus imaging. The 3Nethra Neo Fundus Camera by Forus Health, Bengaluru, India was utilized for screening these infants. It employs a light-weight, hand-held probe with an Light Emitting Diode (LED) light source for capturing images. Using this fundus camera, we monitored the evolution of these three cases and were able to observe a clear regression of the disease after RoP Laser. Surgical intervention was successfully avoided and these babies have remained stable. These results are all the more gratifying when we consider the surgical burden of RoP in India.