NICU Retinal Scans Now an Option at St. Bernards
Arkansas e-Link has provided new equipment to St. Bernards Medical Center in Jonesboro that will allow physicians to conduct exams on infants that previously had to be done outside of the region.
The device, A RetCam Shuttle, was purchased under the Broadband Technology Opportunities Program grant that was awarded to the state in 2010. The device allows physicians to conduct retinal scans on infants to ensure that Retinopathy of prematurity (ROP) doesn’t develop. Previously infants born in Northeast Arkansas at 32 weeks of gestation or less were transported to facilities outside of the region.
“I can see us using the equipment 4-8 times each month,” said Dr. Douglas Seglem, Neonatal Intensive Care Unit (NICU) medical director at St. Bernards.
In the past, routine use of excess oxygen to treat premature babies stimulated abnormal vessel growth. Currently, oxygen can be easily and accurately monitored so this problem is rare. Today the risk of developing ROP depends on the degree of prematurity. Generally, the smallest and sickest premature babies have the highest risk.
There are five stages of ROP ranging from mildly abnormal blood vessel growth to total retinal detachment. “Frequency of exams for infants suffering from ROP depends on what stage they are in. Typically an infant at 30 weeks or younger will get an exam every three weeks. If we detect a problem, then the exams will occur more frequently,” said Seglem.
Early treatment of ROP has been shown to improve a baby’s chances for normal vision. If a problem is found, treatment should start within 72 hours of the exam. Treatment may include cryotherapy or laser therapy. Infants born at 30 weeks of gestation or born weighing fewer than three pounds should have retinal exams at four to nine weeks of age. Babies born at 27 weeks or later usually have their exam at four weeks of age. “This equipment will allow St. Bernards to serve the community better, by being able to do ROP screenings in the NICU,” said Dr. Whit Hall, professor of neonatology at UAMS.
The RetCam Shuttle is a portable device that takes images of the retina which can be uploaded to an Ophthalmologist or be shared in real time. The device is made up of propriety software with a 3-chip CCD camera and has multiple lenses that can be used to obtain different views of the infant’s eyes.
The exam is performed by placing a speculum in the infant’s eye to hold the eyelid open. A small amount of gel is placed in the eye after dilating and numbing drops are administered. The lens of the camera is then placed in the contact gel. The camera’s focus, zoom and light intensity are controlled with foot pedals and the images are recorded and stored on a laptop during the exam.
Jimmie Birdsong, RN and research associate at UAMS in the Department of Neonatology, says this equipment will help allow parents to stay closer to their home. “ With this equipment located in Northeast Arkansas families will be able to benefit from having decreased stress, they will not have to travel, stay overnight or miss work, plus they will be closer to the support of their extended families.”
Currently over 60-percent of the state’s very low birth weight babies (less than 1500 grams) are admitted to either the NICU at Arkansas Children’s Hospital or the Special Care, Intensive Care or Critical Care Nursery at UAMS. The daily census of these two facilities exceeds 100 patients.
For more information on St. Bernards Neonatal Intensive Care Unit visit: http://www.sbrmc.com/centers-of-excellence/womens-and-childrens-services/birthcare-center/neonatal