The Evaluation of Ocular Posterior Segment Findings in 5527 Term Infants Using Smartphone-Based Fundus Imaging

Purpose: To evaluate the two-year fundus examination outcomes of term infants undergoing eye screening. Methods: Retrospective review of our data of term infants at a tertiary care center (Ankara Bilkent City Hospital) from October 2021 to October 2023. All screened infants underwent red reflex test and dilated posterior segment examination. Abnormal ocular findings were documented using smartphone-based imaging system. Results: A total of 5527 full-term babies were enrolled to the study. Abnormal ocular findings were observed in 1031 newborns (18.6%), the most common of which were retinal white lesions in the peripheral retina (13%) (n = 720) and posterior segment hemorrhages (4.3%) (n = 243). Other findings included congenital hypertrophy of the retinal pigment epithelium (n = 14), choroidal nevus (n = 11), idiopathic peripheral retinal scar (n = 9), chorioretinal coloboma (n = 6), optic nerve coloboma (n = 4), familial exudative vitreoretinopathy (n = 4), optic nerve large cup (n = 2), optic nerve hypoplasia (n = 2), retinal calcification (n = 2), optic nerve pit (n = 2), morning glory disc anomaly (n = 1), vascular loop on the optic disc (n = 1), retinoblastoma (n = 1), X-linked retinoschisis (n = 1), congenital toxoplasmosis (n = 1), thread-shaped white lesion (n = 1), combined hamartoma of the retina and the retinal pigment epithelium (n = 1), foveal hypoplasia (n = 1), retinal dystrophy (n = 1), and astrocytic hamartoma (n = 1). Conclusions: Detailed eye examinations of term infants can reveal a range of ocular and/or systemic abnormalities that would not be caught through pupillary red reflex test. Smartphone-based fundus imaging is a simple and effective method for documenting findings.