Telemedicine Helps Surgeon Prevent Blindness In Premature Infants
In collaboration with the Armenia Eye Care Project (AECP), Thomas C. Lee, MD, from The Vision Center at Childrens Hospital Los Angeles recently traveled to Armenia in an effort to prevent blindness in premature infants through the launch of a new international telemedicine system.
Through the AECP, local NICUs (neonatal intensive care units) in Armenia installed two RetCams, which are advanced imaging devices that can scan the retinas of premature infants. This imaging device was first developed by ophthalmologists at Childrens Hospital Los Angeles 25 years ago.
Using the RetCams, the first in Armenia, the visiting international team of ophthalmologists examined more than 50 infants at seven NICUs in Yerevan and operated on five premature infants who suffered from retinopathy of prematurity (ROP). ROP is an eye disease that affects the developing vessels of premature infants between the eighth and ninth month of pregnancy. These abnormal blood vessels grow and spread throughout the retina, the paper thin tissue that lines the back of the eye. In Armenia, each year about 500-600 infants will develop some form of ROP and between 100–200 will become legally blind.
“The five children we treated, who would otherwise have gone blind from ROP, now have a good chance of growing up with functional vision,” said Dr. Lee. In addition to treating the premature infants, the visiting team held workshops where 200 local physicians learned about the RetCam and how to diagnose and treat ROP with a diode laser. Dr. Lee says the new program takes the concept of telemedicine to a new level.
“In this program, we will not just be treating patients remotely — we will be training Armenian physicians via the Internet on how to perform complex eye surgery using advanced medical equipment," said Dr. Lee.
With the remote medical education program, Armenian doctors will be able to receive training that is the equivalent of a medical residency or fellowship. The doctors will scan the retinas of infants in local NICUs and send the images to The Vision Center at Childrens Hospital Los Angeles via the Internet to experienced retina surgeons like Dr. Lee, who will then review them and discuss appropriate treatment.
The new program is expected to train eight to ten Armenian physicians every six months. Dr. Lee serves as director of the Retina Institute in The Vision Center and leads one of the most world- renowned surgical initiatives for ROP and other retinal diseases. In recent years ROP has become a major problem in Armenia and other developing countries as the healthcare infrastructure has advanced, according to Dr. Lee.
“Every year in Armenia, many children are born prematurely, survive due to the NICU, only to grow up blind because of ROP and place economic burdens on their families and state institutions,” said Dr. Lee.
All of these items – the June conference and medical mission, the diode laser, the two RetCam donations and the first phase of the remote medical education program – were made possible by the Armenian Eye Care Project and Glenda and Luther Khachigian. The Project will continue to fund the program for the next two years after which it will transition to the stewardship of the Armenian Ministry of Health.
Roger Ohanesian, M.D., a leading Orange County ophthalmologist, founded the AECP in 1992. The Project has made 37 medical missions to Armenia, provided clinicians who have seen more than 250,000 patients and donated $39 million in medicines and medical equipment to local hospitals.
The international team of surgeons also included Dr. Robison V. Paul Chan, Director, Retina Service at Weill Cornell Medical College; Dr. Patrick Walsh, a recognized neonatologist from Anaheim, California; and Dr. James E. Smith, recognized as a world-leader in ROP treatment from Australia.
After originally being developed at Childrens Hospital, the RetCams used by the project are now manufactured by Clarity Medical Systems (Pleasanton, Calif.) and in use at hospitals throughout the U.S. and Europe.