RetCamTMを用いた未熟児網膜症の遠隔診療

Management of retinopathy of prematurity through telemedicine using wide-angle fundus photography

要約　目的：広角眼底カメラを用いた未熟児網膜症の遠隔診療の状況の報告。対象と方法：過去35か月間に福山医療センターの新生児集中治療室で治療した新生児153名を対象とした。いずれも在胎週数35週未満（平均32.7週），または出生体重1,800g未満（平均1,693g），または高濃度酸素を使用していた。センターの小児科医が広角デジタル眼底カメラ（RetCam^TM120）で撮影した眼底写真を眼科医に送信する方法と，眼科医の往診とを併用した。結果：眼底写真の送信は計83回で平均間隔12.2日，眼科医の往診は計51回で平均間隔20.4日であった。153名中26名（17％）に未熟児網膜症が発症した。8名に網膜光凝固を行い，網膜症は鎮静化した。結論：広角眼底カメラを用いた未熟児網膜症の遠隔診療は，眼科医の往診回数を減少させ，特に問題なく継続できた。

Abstract.　Purpose：To report the status of management of retinopathy of prematurity（ROP）through telemedicine using a wide-angle fundus camera. Cases and Method：This study was made on 153 babies treated in the neonatal intensive care unit（NICU）during the past 35 months at Fukuyama Medical Center in western Japan. The cases had either been born after gestational age of 35 weeks or less（average 32.7 weeks）,with birthweight of 1,800 g or less（average 1,693 g）,or were treated by supplemental oxygen. ROP was managed either by visit of ophthalmologist or by sending fundus photographs taken with a wide-angle fundus camera（RetCam^TM）. Results：Babies in NICU were seen by visiting ophthalmologist 51 times or at an interval of 20.4 days in average. Fundus photographs were sent from the center 83 times at an interval of 12.2 days in average. ROP developed in 26 cases（17％）. Eight cases with advanced ROP were treated by photocoagulation with fair outcome. Conclusion：Management of ROP by telemedicine using fundus photographs resulted in reduced frequency of bedside examination by ophthalmologist with no major problems.