The use of telemedicine for retinopathy of prematurity (ROP) screening has been supported by numerous studies [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. However, telemedicine-based examination following treatment for ROP has not been previously reported. Infants require continued screening for at least 10 weeks following laser treatment of treatment-warranted retinopathy of prematurity (TW-ROP) to ensure involution of ROP occurs and to monitor for the development of progressive disease and retinal detachment [17, 18].

The Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) is a telemedicine-based program for in-hospital screening of high-risk infants for TW-ROP at 6 satellite neonatal intensive care units (NICUs) in Northern California. All infants at-risk for ROP in the participating NICUs were screened primarily with telemedicine-based examinations as described previously [1, 5,6,7,8,9]. Using data from this initiative, the use of telemedicine-based examinations for infants after laser treatment for TW-ROP was evaluated.

The study was approved by the Institutional Review Board (IRB 8752) at Stanford University School of Medicine. All research was conducted in compliance with human subject regulations and in accordance with the tenets of the Declaration of Helsinki.

All infants enrolled in the SUNDROP initiative who underwent laser photocoagulation for TW-ROP from December 1, 2005 to December 30, 2015 were identified. The number of examinations after treatment was recorded, as was the duration of screening and number of examinations following treatment. Medical records were reviewed to identify any infants who had reactivation of ROP after treatment.

Over the study period, of 715 infants (1430 eyes) screened in the SUNDROP protocol, 37 (74 eyes) were treated for TW-ROP with laser photocoagulation. Of those, 25 (50 eyes) continued to undergo telemedicine-based examinations after treatment. An average of 6.24 (range 1–17) telemedicine-based examinations were performed over a course of an average of 7.76 weeks after treatment (range 2–30) for each infant. An example of screening photographs is shown in Fig. 1. By review of medical records, none of the infants had reactivation of disease or developed retinal detachment.

Fig. 1
figure 1

a–d Telemedicine photos obtained 6 weeks after laser photocoagulation for retinopathy of prematurity in the right eye demonstrating regression of retinopathy of prematurity and e–h photos of the left eye in the same infant also showing regression of disease

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Based on this preliminary data, telemedicine-based examination following treatment for ROP is safe and efficacious in combination with the work of ROP specialists.