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Outcome of universal newborn eye screening with wide-field digital retinal image acquisition system: a pilot study
1Retina and Vitreous services, Shri Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneswar, India.
Insights
Universal newborn eye screening using wide-field digital retinal imaging (WFDRI) identified ocular abnormalities in 14.93% of infants. While WFDRI offered economic benefits and manpower savings, its advantage over the red reflex test for detecting critical conditions was marginal.
Area of Science:
- Ophthalmology
- Neonatal Care
- Public Health
Background:
- Early detection of ocular pathologies in newborns is crucial for preventing vision impairment.
- Wide-field digital retinal imaging (WFDRI) offers advanced visualization of the neonatal retina.
- Assessing the efficacy and economic impact of universal newborn eye screening is essential.
Purpose of the Study:
- To evaluate the effectiveness and outcomes of universal newborn eye screening using WFDRI.
- To determine the incidence of ocular abnormalities in apparently healthy newborns.
- To assess the economic benefits and manpower savings associated with WFDRI screening.
Main Methods:
- A pilot study involving 1152 apparently healthy newborns in Eastern India.
- Examination included external eye assessment, red reflex test, and WFDRI (RetCam II).
- Pathologies detected, monetary gain, and skilled manpower saved were documented and compared with existing literature.
Main Results:
- Ocular abnormalities were detected in 172 (14.93%) infants.
- Retinal hemorrhage was the most common finding (153 babies), resolving spontaneously.
- Congenital glaucoma was identified in 2 infants, requiring medical or surgical intervention.
Conclusions:
- Universal neonatal eye screening with WFDRI detects treatable ocular pathologies and offers economic advantages.
- WFDRI screening resulted in significant savings in skilled manpower and a net monetary gain.
- However, the marginal benefit over the red reflex test for detecting treatment-warranting pathologies warrants further consideration.
Abstract:
PurposeTo evaluate the outcome of universal newborn eye screening with wide-field digital retinal imaging (WFDRI) system.MethodsIn this pilot study, we examined 1152 apparently healthy newborn infants in the obstetrics and gynecology ward of a civil hospital in Eastern India over 1.5 years. The examination included external eye examination, red reflex test and fundus imaging by WFDRI (RetCam II, Clarity medical system, Pleasanton, CA, USA) by a trained optometrist. The pathologies detected, net monetary gain and skilled manpower saved were documented. The results were compared with three similar studies thus far published in the literature.ResultsOcular abnormality of any kind was seen in 172 (14.93%) babies. Retinal hemorrhage in 153 babies (88.9% of all abnormal findings) was the most common abnormality; it was bilateral in 118 (77.12%) babies and 4 babies had foveal hemorrhage. Other abnormalities included vitreous hemorrhage (n=1), congenital glaucoma (n=2), uveal coloboma (n=2), retinopathy mimicking retinopathy of prematurity (n=2), and cystic fovea (n=3). The retinal hemorrhages resolved spontaneously in all eyes. One baby with congenital glaucoma received surgery and the other was treated medically. The benefits included savings in skilled manpower, a net monetary gain of INR 4.195 million (US$ 62,612) and skilled manpower saving by 319.4 h.ConclusionsThe universal neonatal eye screening using WFDRI detected pathologies that needed immediate care or regular follow up; saved skilled manpower with a net monetary gain. But compared to a red reflex test the benefits were marginal in terms of detecting treatment warranting ocular pathologies.
