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Systemic effects of screening for retinopathy of prematurity
D E Laws1, C Morton, M Weindling
1Department of Ophthalmology, Walton Hospital, Liverpool.
Insights
Retinopathy of prematurity (ROP) screening may cause temporary blood pressure increases and slight oxygen saturation drops in infants. These changes, likely due to mydriatics and examination stress, were not clinically significant.
Area of Science:
- Neonatal ophthalmology
- Pediatric critical care
Background:
- Screening for retinopathy of prematurity (ROP) is crucial for preventing blindness in premature infants.
- Systemic physiological responses during ROP screening are not fully understood.
Purpose of the Study:
- To evaluate systemic complications during ROP screening examinations.
- To specifically assess physiological changes related to the physical examination component of ROP screening.
Main Methods:
- Prospective monitoring of oxygen saturation, pulse rate, and blood pressure in 110 infants undergoing ROP screening.
- Measurements taken before, during, and after the examination, including after topical mydriatic administration.
Main Results:
- Transient increases in diastolic and systolic blood pressure observed after mydriatic use and the examination.
- A minor decrease in oxygen saturation and an increase in pulse rate noted post-examination, with no significant changes in infants on methylxanthine therapy.
- No clinically significant adverse events were recorded during or after the screening procedures.
Conclusions:
- Elevated blood pressure may be linked to topical mydriatics and the stress of the ROP screening examination.
- Physiological changes observed are generally transient and not clinically significant, supporting the safety of current ROP screening protocols.
Aims:
To detect systemic complications of screening for retinopathy of prematurity (ROP), paying particular attention to the physical examination.
Methods:
Oxygen saturation, pulse rate, and blood pressure were monitored before, during, and after 110 ROP screening examinations.
Results:
Following topical mydriatics diastolic blood pressure was elevated by a mean of 6 (SD 7.2) mm Hg. Immediately after the examination there was a further rise in both systolic and diastolic pressure of 4.3 (14.5) mm Hg and 3.3 (11.6) mm Hg, respectively. Oxygen saturation and pulse rate remained stable during the control period and administration of eyedrops. Saturation fell by a median of 3% (95% confidence interval plus or minus 1.2%) after the examination while there was rise in pulse rate of 7 (SD 23.1) beats per minute. This change in pulse rate was not observed in infants on concurrent methylxanthine therapy. No infant had clinically significant changes at the end of the study.
Conclusion:
The initial changes in blood pressure may represent side effects of topical mydriatics but the later changes following the physical examination may be an additional response to the stress of ROP screening.