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Look what else we found--clinically significant abnormalities detected during routine ROP screening
Chaitra Jayadev, Anand Vinekar1, Noel Bauer
1Department of Pediatric Retina, Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bengaluru, Karnataka, India.
Insights
Routine eye screening for premature infants unexpectedly identified various serious conditions beyond retinopathy of prematurity (ROP). This highlights the value of digital imaging in early detection of sight-threatening infant eye diseases.
Area of Science:
- Ophthalmology
- Neonatal Care
- Medical Imaging
Background:
- Premature infants require regular eye examinations to detect conditions like retinopathy of prematurity (ROP).
- Digital imaging, such as Retcam, is increasingly used for infant eye screening.
- Serendipitous findings during ROP screening can reveal other ocular pathologies.
Purpose of the Study:
- To document the range of anterior and posterior segment diagnoses found in Asian Indian premature infants.
- To identify conditions detected incidentally during standard retinopathy of prematurity (ROP) screening.
- To assess the utility of digital ocular imaging in a premature infant population.
Main Methods:
- Retrospective review of Retcam imaging sessions from 2011.
- Inclusion criteria: infants born <2001g and/or <34.1 weeks gestation undergoing ROP screening.
- Standardized seven-image protocol including anterior segment, disc, macula, and four quadrants.
Main Results:
- 111 out of 1450 infants (7.66%) had non-ROP diagnoses.
- Anterior segment issues included cataract, lid abnormalities, anophthalmos, microphthalmos, and corneal diseases.
- Posterior segment findings included retinal hemorrhages, cherry red spots, and neonatal uveitis; two retinoblastomas were detected.
Conclusions:
- Digital ocular imaging during ROP screening can serendipitously detect significant, potentially life-threatening infant eye conditions.
- Early detection of these conditions through routine screening can lead to timely medical or surgical intervention.
- Findings support advocating for universal infant eye screening programs utilizing digital imaging.
Purpose:
The purpose of this study was to report the spectrum of anterior and posterior segment diagnoses in Asian Indian premature infants detected serendipitously during routine retinopathy of prematurity (ROP) screening during a 1 year period.
Methods:
A retrospective review of all Retcam (Clarity MSI, USA) imaging sessions during the year 2011 performed on infants born either <2001 g at birth and/or <34.1 weeks of gestation recruited for ROP screening was performed. All infants had a minimum of seven images at each session, which included the dilated anterior segment, disc, and macula center and the four quadrants using the 130° lens.
Results:
Of the 8954 imaging sessions of 1450 new infants recruited in 2011, there were 111 (7.66%) with a diagnosis other than ROP. Anterior segment diagnoses seen in 31 (27.9%) cases included clinically significant cataract, lid abnormalities, anophthalmos, microphthalmos, and corneal diseases. Posterior segment diagnoses in 80 (72.1%) cases included retinal hemorrhages, cherry red spots, and neonatal uveitis of infective etiologies. Of the 111 cases, 15 (13.5%) underwent surgical procedures and 24 (21.6%) underwent medical procedures; importantly, two eyes with retinoblastoma were detected which were managed timely.
Conclusions:
This study emphasizes the importance of ocular digital imaging in premature infants. Visually significant, potentially life-threatening, and even treatable conditions were detected serendipitously during routine ROP screening that may be missed or detected late otherwise. This pilot data may be used to advocate for a possible universal infant eye screening program using digital imaging.
