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Red reflex test screening for neonates: A systematic review and meta analysis
Amar Taksande1, Patel Zeeshan Jameel1, Bharati Taksande2
1Department of Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India.
Indian Journal of Ophthalmology
|July 25, 2021
Summary
The red reflex test (RRT) is a highly sensitive and specific screening tool for detecting newborn eye abnormalities. This systematic review confirms its diagnostic accuracy, supporting its wider implementation in neonatal care.
Area of Science:
- Ophthalmology
- Neonatal Screening
- Diagnostic Accuracy
Background:
- Red reflex test (RRT) screening is not standard in many low- and middle-income countries before hospital discharge.
- Early detection of neonatal ocular abnormalities is crucial for preventing long-term vision impairment.
Purpose of the Study:
- To systematically evaluate the diagnostic accuracy of the red reflex test for detecting ocular abnormalities in newborns.
- To assess the RRT's effectiveness as a screening tool in the neonatal population.
Main Methods:
- Systematic review and meta-analysis of 11 studies.
- Data sources included PubMed, EMBASE, Scopus, Web of Science, and Cochrane.
- Quality assessment using QUADAS-2; analysis using random effects models.
Main Results:
- Pooled sensitivity: 23% (95% CI: 21-24%); Pooled specificity: 98% (95% CI: 98-98%).
- Positive Likelihood Ratio (PLR): 32.52; Negative Likelihood Ratio (NLR): 0.69.
- Diagnostic Odds Ratio (DOR): 138.48; AUC: 0.98 ± 0.02; Q* index: 0.95 ± 0.045.
Conclusions:
- The red reflex test demonstrates high sensitivity and specificity for detecting anterior segment abnormalities in newborns.
- Findings support the RRT as a valuable diagnostic tool for neonatal eye screening.
