Telemedicine achieves 0.93 to 0.97 sensitivity and specificity for screening retinopathy of prematurityTelemedicine Shows High Accuracy for Screening Retinopathy of Prematurity

Ophthalmology. Retina Published August 4, 2026 Study authors: Pandiri Srujay, Chaaya Celine, Brant Arthur, Hoyek Sandra, Bejjani Romy, Malek Davina A, Zhao Yan, B… PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Note that telemedicine offers high sensitivity and specificity for ROP screening, especially in low-resource settings.

This meta-analysis evaluates the diagnostic performance of telemedicine technology for identifying referral-warranted (RW) and treatment-required (TR) retinopathy of prematity (ROP). The analysis included 3527 patients and 6149 eyes to determine if remote digital fundus imaging is a viable screening tool.

Key findings indicate high diagnostic accuracy. Sensitivity for RW-ROP was 0.93, while sensitivity for TR-ROP was 0.97. Specificity was also high, recorded at 0.95 for RW-ROP and 0.97 for TR-ROP. The analysis noted that results from post-2010 studies generally showed higher values across all metrics compared to pre-2010 studies. Additionally, geographic comparisons showed variations in performance between US and non-US settings.

A primary limitation identified is the significant variability in specificity for RW-ROP (I2 = 91.2%). The evidence certainty was graded as moderate for sensitivity and high for specificity of RW-ROP using the GRADE approach; certainty for TR-ROP was graded as high.

Clinically, remote digital fundus imaging may be an option for ROP screening, particularly in low-resource areas. However, the authors suggest that formal training for both photographers and graders is necessary to ensure consistent outcomes.

How this fits prior evidence

This meta-analysis addresses a gap in identifying effective screening methodologies for retinopathy of prematurity (ROP). While prior coverage has focused on pharmacological interventions such as anti-VEGF treatments, DHA/ARA supplementation, and the impact of Erythropoietin or IGF-1 on outcomes, this study focuses on the diagnostic utility of telemedicine. It provides evidence that remote imaging can achieve high sensitivity (0.93 to 0.97) and specificity (0.95 to 0.97) for identifying infants requiring referral or treatment.

Researchers analyzed a large amount of data involving over 3,500 premature infants and more than 6,000 eyes. The study looked at how well telemedicine technology could identify two types of retinopathy of prematurity (ROP). These are eye conditions that can affect vision in babies born early.

The results showed that telemedicine was very accurate. It had high sensitivity and specificity for both referral-warranted cases and treatment-required cases. This means the technology is reliable at identifying which infants need closer monitoring or immediate medical care. The study also noted that accuracy scores improved in studies conducted after 2010.

While the results are promising, there was some variation in how well the system identified certain cases depending on location. Because of this variability, experts suggest that anyone using these tools should receive formal training. This technology may be a helpful option for screening infants in areas where specialists are hard to reach.

What this means for you:

Telemedicine shows high accuracy for identifying eye conditions in premature infants, especially in remote areas.

Common questions

How accurate is telemedicine for screening ROP?

The study found high accuracy levels for both types of cases. For referral-warranted cases, sensitivity was 0.93 and specificity was 0.95. For treatment-required cases, both sensitivity and specificity were reported at 0.97. These numbers indicate that the technology is very reliable at identifying infants who need medical attention.

Can telemedicine help babies in remote areas?

Yes, the study suggests that remote digital fundus imaging can be an option for screening retinopathy of prematurity. This is especially useful in low-resource areas where specialized eye care might be harder to access quickly.

Are there any concerns with using telemedicine for these screenings?

The study noted significant variability in specificity for some cases. Because of this, experts suggest that formal training is necessary for the people taking the photos and those grading the images to ensure the best results.

Study Details

Study typeMeta analysis

Sample sizen = 3,527

EvidenceLevel 1

PublishedAug 2026

PMID41951053

View Original Abstract ↓

TOPIC: The purpose of this study was to report the sensitivities and specificities of telemedicine technology used to screen for referral-warranted (RW)-retinopathy of prematurity (ROP) and treatment-required (TR)-ROP. CLINICAL RELEVANCE: Retinopathy of prematurity is a leading cause of blindness in premature infants. Tele-ROP has emerged as a novel method to help screen for ROP in low-resource locations and showcases significant promise. METHODS: PubMed, Embase, and Web of Science databases were searched from January 2000 to October 2024. Studies reporting sensitivities and specificities of RW-ROP or TR-ROP were included in the meta-analysis. These values were combined using random-effects meta-analysis. Risk of bias was determined via the Newcastle Ottawa Scale and Quality Assessment of Diagnostic Accuracy Studies-2 tool. The study protocol was registered and published on the International Prospective Register of Systematic Reviews (CRD42024608378). RESULTS: Of 905 identified studies, 16 studies met the inclusion criteria and were thus included in the meta-analysis. Of 3527 patients, 6149 eyes were studied. The sensitivity in the RW group was 0.93 (95% CI, 0.83-0.98), with low heterogeneity between studies (I2 = 0.0%; P = 0.75), and the overall specificity was 0.95 (95% CI, 0.85-0.98), with heterogeneity between studies (I2 = 91.2%; P < 0.001). Certainty of evidence was graded as moderate for sensitivity and high for specificity using the GRADE approach. Regarding the TR-ROP group, the sensitivity was 0.97 (95% CI, 0.92-0.99), with low heterogeneity between studies (I2 = 0.0%; P = 0.97), and the specificity was 0.97 (95% CI, 0.91-0.99), with heterogeneity between studies (I2 = 88.2%; P < 0.001). Certainty of evidence was graded as high. Post-2010 studies had greater sensitivities and specificities for RW-ROP: P < 0.001 and P = 0.77, respectively. Treatment-required -ROP sensitivity and specificity were higher in studies conducted after 2010 than prior: P = 0.06 and P < 0.001, respectively. Sensitivity and specificity for US vs. non-US-based studies were (0.83 vs. 0.92, P = 0.012) and (0.97 vs. 0.88, P = 0.04), respectively. Specificity for TR-ROP between US vs. non-US-based studies was 0.98 vs. 0.95, P < 0.001, respectively. CONCLUSION: Remote digital fundus imaging may be an option for ROP screening, particularly in low-resource areas. There was significant variability. This suggests a need for continued formal training for both photographers and graders. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Telemedicine achieves 0.93 to 0.97 sensitivity and specificity for screening retinopathy of prematurityTelemedicine Shows High Accuracy for Screening Retinopathy of Prematurity

How this fits prior evidence

Common questions

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Telemedicine achieves 0.93 to 0.97 sensitivity and specificity for screening retinopathy of prematurityTelemedicine Shows High Accuracy for Screening Retinopathy of Prematurity

How this fits prior evidence

Common questions

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