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Accidentally diagnosed ocular abnormalities identified during close screening for retinopathy of prematurity
Taylan Ozturk1, Ceren Durmaz Engin2, Ezgi Karatas Yigitaslan1
1Department of Ophthalmology, 37508Dokuz Eylul University School of Medicine, Izmir, Turkey.
Insights
Ophthalmologists screening premature infants for retinopathy of prematurity (ROP) frequently discover other serious eye conditions. Early detection of these coexisting ocular findings is crucial for preserving vision and life.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Premature infants undergo screening for retinopathy of prematurity (ROP).
- Routine ocular examinations are standard for preterm infants.
- Wide-angle digital imaging aids in detecting vitreoretinal pathologies.
Purpose of the Study:
- To document diverse ocular findings serendipitously detected during ROP screening.
- To analyze the spectrum of non-ROP ocular pathologies in preterm infants.
- To highlight the importance of comprehensive eye exams in this population.
Main Methods:
- Retrospective chart review of 1568 preterm infants screened for ROP.
- Systematic recording of all ocular lesions excluding ROP.
- Inclusion of external eye, pupillary reflex, and anterior/posterior segment examinations.
- Utilization of wide-angle digital retinal imaging for follow-up.
Main Results:
- 19.2% of infants (296/1568) presented with non-ROP ocular abnormalities.
- Tunica vasculosa lentis (25%), vitreous/retinal hemorrhages (17.2%), and retinal white lesions (16.6%) were most common.
- The retina was the most frequently affected site; other findings included optic disc cupping, congenital cataract, optic nerve hypoplasia, and choroidal nevus.
- Life-threatening conditions like lipemia retinalis and retinoblastoma were also identified.
Conclusions:
- Comprehensive ophthalmologic examination is essential during ROP screening in premature infants.
- Clinicians must remain vigilant for coexisting ocular findings.
- These incidental findings can range from sight-threatening to life-threatening.
Purpose:
To report the variety of ocular findings which have been identified serendipitously during the screening for retinopathy of prematurity (ROP) in a tertiary referral center during seven-year period.
Methods:
The charts of 1568 preterm infants who screened for ROP were reviewed retrospectively. Any ocular lesion except for ROP were noted. All infants had undergone routine ocular examination of the external eye, pupillary light reflex, anterior and posterior segment. Wide-angle digital retinal image acquisition system for any vitreoretinal pathology requiring a close follow-up had been utilized.
Results:
Abnormal ocular findings other than ROP were diagnosed in 296 infants (19.2%). Tunica vasculosa lentis was the most common finding (25%) followed by vitreous or retinal hemorrhages (17.2%) and retinal white lesions (16.6%). Retina was the most frequently involved anatomic site. Other frequent ocular findings included optic disc cupping, congenital cataract, optic nerve hypoplasia, choroidal nevus, persistent fetal vasculature, lid hemangioma, and tilted disc. However, life-threatening pathologies such as lipemia retinalis and even retinoblastoma were also diagnosed.
Conclusion:
A duly ophthalmologic examination is mandatory in premature infants for ROP screening. During such examinations, ophthalmologists must be aware of coexisting ocular findings; which could be sight-threatening or even life-threatening.
