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[Selective fundus screening for high-risk newborns: a realistic move in the Chinese mainland]
1Department of Ophthalmology, Xijing Hospital, Air Force Military Medical University, Eye Institute of Chinese PLA, Xi'an 710032, China.
Insights
Selective newborn fundus screening is recommended for high-risk infants to prevent retinopathy of prematurity (ROP). While general screening has benefits, selective screening optimizes scarce resources and minimizes risks associated with examining all neonates.
Area of Science:
- Ophthalmology
- Neonatology
- Public Health
Context:
- China's advancements in retinopathy of prematurity (ROP) prevention and treatment.
- The ongoing debate regarding the scope of newborn fundus screening.
- National ROP guidelines and criteria for high-risk newborns.
Purpose:
- To evaluate the feasibility and practicality of selective versus universal newborn fundus screening.
- To address the optimal allocation of medical resources for ROP detection.
- To discuss the risks and benefits associated with different screening strategies.
Summary:
- Selective fundus screening for high-risk newborns is deemed practical and efficient.
- Universal screening, while beneficial for early detection, faces challenges in implementation and carries risks.
- Prioritizing high-risk infants ensures rational use of limited medical resources.
Impact:
- Provides a practical approach to managing ROP screening in clinical settings.
- Informs policy decisions on newborn eye screening programs.
- Contributes to the effective prevention and treatment of ROP in neonates.
Abstract:
Owing to the popularization of fundus screening for high-risk prematurity promoted by the state, the prevention and treatment of retinopathy of prematurity (ROP) in China has achieved remarkable results in recent years. Accordingly, the applicable population scope for newborn fundus screening is under heated discussion. Is it better to screen for all neonates or selective high-risk newborns, who meet the national ROP guidelines, have a history of familial or/and hereditary eye diseases or a systemic disease related to the eye after birth, or show an abnormal eye appearance or suspicious eye diseases in the primary care examination? Despite the advantages of general screening in detecting and treating some malignant eye diseases in a timely manner, the conditions for carrying out general newborn screening are not mature, and there are certain risks in the fundus examination of children. This article points out that the rational use of existing scarce medical resources to carry out selective fundus screening for newborns with high risks of eye diseases is practical in clinical work.
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