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Early detection of ocular abnormalities in a Chinese multicentre neonatal eye screening programme-1-year result
Ping Fei1, Zijiang Liu2, Liying He3
1Department of Ophthalmology, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Insights
A multicentre study found a high prevalence of newborn eye abnormalities, with retinal hemorrhage being most common. Early detection through neonatal eye screening programs is crucial for timely intervention and promoting pediatric eye health.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Background:
- Early detection of ocular abnormalities in newborns is critical for timely diagnosis and treatment.
- Neonatal eye examinations play a vital role in identifying potential vision-threatening conditions.
- A prospective study was conducted to evaluate a neonatal eye screening program in China.
Purpose of the Study:
- To assess the 1-year results of a multicentre prospective neonatal eye examination program.
- To determine the prevalence of ocular abnormalities in newborns using a wide-field digital imaging system.
- To evaluate the need for further intervention or observation for detected ocular abnormalities.
Main Methods:
- A multicentre prospective study involving nine hospitals in China from July 2016 to June 2017.
- Ocular examinations performed on newborns within 28 days of birth using a wide-field digital imaging system.
- Data analysis focused on the prevalence and types of ocular abnormalities detected.
Main Results:
- 13,514 (20.91%) of 64,632 newborns had ocular abnormalities, with retinal hemorrhage (11.83%) being the most frequent.
- 59.44% of abnormalities required further observation or intervention, with 0.41% needing immediate attention (e.g., congenital cataract, retinoblastoma).
- 1.75% required close follow-up for conditions like retinopathy of prematurity (ROP).
Conclusions:
- The study revealed a high prevalence of ocular abnormalities in newborns.
- A significant percentage of congenital eye pathologies necessitate further referral and treatment.
- Neonatal ocular screening programs are effective in early detection and promoting pediatric eye health.
Purpose:
Early detection of ocular abnormalities in newborns is essential for timely diagnosis and treatment. This study aimed to assess the 1-year result of a multicentre prospective neonatal eye examination programme with wide-field digital imaging system in China.
Methods:
A multicentre collaborative prospective study group for neonatal eye screening was established in nine hospitals, including eight Maternal and Children's Hospitals, and one general hospital across China from July 2016 to June 2017. Ocular examinations were performed on newborns within 28 days after birth using a wide-field digital imaging system. Data were reviewed and analysed. The primary outcome was the prevalence of ocular abnormalities in neonates.
Results:
We detected 13 514 (20.91%) abnormal cases in 64 632 newborns. The most frequent abnormality was retinal haemorrhage (RH; 11.83%). Most of mild RH resolved spontaneously. Among those who were beyond retinopathy of prematurity (ROP) screening criteria of China (gestational age ≥32 w and birthweight ≥2000 g), the total number of neonates with ocular abnormality was 12 218/62 799(19.45%). 59.44% of neonatal ocular abnormalities detected (accounting for 11.56% of all the screened population) needed further interference or observation. Among them, 258 patients (0.41% of all the screened population) needed immediate or timely intervention, including congenital cataract, retinal detachment, retinoblastoma and other ocular abnormalities. One thousand and ninety-eight patients (1.75% of all the screened neonates) should be followed up closely and needed further diagnosis or intervention if necessary, such as ROP or ROP-like retinopathy, familial exudative vitreoretinopathy and persistent hyperplasia of primary vitreous. Five thousand nine hundred and six patients (9.4%) with minor clinical significance needed short-term follow-up.
Conclusions:
This prospective multicentre study of newborn ocular examination showed a relatively high prevalence of ocular abnormalities. There are a relatively high percentage of congenital eye pathology that required further referral and treatment in those neonates who were not screened routinely. According to the benefits and risks associated with neonatal eye examinations, neonatal ocular screening programme can detect ocular abnormalities at the very early stage and may play a positive role in promoting paediatric eye health.
