Retinopathy of Prematurity (ROP) Research Projects 

Retinopathy of Prematurity (ROP)

Retinopathy of prematurity (ROP) is an eye disease that occurs in premature infants, primarily those born before 31 weeks or with a low birth weight. It is caused by abnormal blood vessel growth in the retina. In severe cases, ROP can lead to retinal detachment and blindness.

With 15 million babies born preterm every year, it is an important problem in child eye health which is rising as the number of children born prematurely increases with improved access to neonatal care and therefore increasing survival.

To treat ROP and prevent sight loss in children, it must be accurately diagnosed early with timely screening after birth. Current screening methods are costly and rely on specialized equipment that is often unavailable in low-resource settings.

Current Research

We are running a study in Nepal testing a telemedicine screening model which will allow non-specialists to do the ROP screening allowing for greater scale up of services. We will then compare human assessment of the images from both devices against an AI algorithm. In the second phase of the study will then compare the current (expensive) standard equipment against a newly developed cheaper smartphone-based camera.

The study is a prospective cross-sectional comparison study over three sites in Kathmandu. Participants will have images taken with standard widefield digital fundus imaging cameras and then new smartphone-based fundus imaging systems.

The study aims to provide evidence that a) non-specialists can be trained to do ROP screening and b) the AI model could help screen which babies would need to be referred, which would reduce the burden on doctors and allow scale-up of screening. We also hope to show that the smartphone-based camera is comparable to the current standard device which would remove the barrier of high equipment costs. Together this would reduce the numbers of children unnecessarily blind or vision impaired from ROP.

Retinopathy of Prematurity Network

An important tool in the fight against ROP is increased awareness, training and skills among health care professionals dealing with newborns. The ROP Network was established by the International Centre for Eye Health to reduce unnecessary blindness from retinopathy of prematurity in low resource settings, through south-south information sharing and training, capacity-strengthening, policy engagement, and context-specific research. Our aims are to bring together all those working to reduce blindness from ROP for the benefit of all, and especially the children and their families.

Find out more about the network here: https://iceh.lshtm.ac.uk/the-retinopathy-of-prematurity-network/

For more information on our ROP work, please email Aeesha.Malik@lshtm.ac.uk

Acknowledgements

We would like to thank Velux Stiftung for funding for the Nepal AI work.

We would also like to thank Nepal Netra Jyoti Sangh, Tribhuvan University Teaching Hospital, Kathmandu Medical College and the Tilganga Institute of Ophthalmology for their collaboration on the Nepal AI project.

Publications

Ademola-Popoola DS, Fajolu IB, Gilbert C, Olusanya BA, Onakpoya OH, Ezisi CN, Musa KO, Chan RVP, Okeigbemen VW, Muhammad RC, Malik ANJ, Adio AO, Bodunde OT, Rafindadi AL, Oluleye TS, Tongo OO, Badmus SA, Adebara OV, Padhi TR, Ezenwa BN, Obajolowo TS, Olokoba LB, Olatunji VA, Babalola YO, Ugalahi MO, Adenekan A, Adesiyun OO, Sahoo J, Miller MT, Uhumwangho OM, Olagbenro AS, Adejuyigbe EA, Ezeaka CVC, Mokuolu O, Ogunlesi TA, Ogunfowora OB, Abdulkadir I, Abdullahi FL, Fabiyi AT, Hassan LHL, Baiyeroju AM, Opara PI, Oladigbolu K, Eneh AU, Fiebai BE, Mahmud-Ajeigbe FA, Peter EN, Abdullahi HS. Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020. BMJ Open Ophthalmol. 2021 Aug 23;6(1):e000645. doi: 10.1136/bmjophth-2020-000645. PMID: 34514173; PMCID: PMC8383855.

Gilbert C, Malik ANJ, Nahar N, Das SK, Visser L, Sitati S, Ademola-Popoola DS. Epidemiology of ROP update – Africa is the new frontier. Semin Perinatol. 2019 Oct;43(6):317-322. doi: 10.1053/j.semperi.2019.05.002. Epub 2019 May 11. PMID: 31151778.

Gilbert C, Malik ANJ, Vinekar A. Artificial Intelligence for ROP Screening and to Assess Quality of Care: Progress and Challenges. Pediatrics. 2021 Mar;147(3):e2020034314. doi: 10.1542/peds.2020-034314. PMID: 33637647.