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Retinal examinations in infants after extracorporeal membrane oxygenation
M M Varn1, M L Donahue, R A Saunders
1N. Edgar Miles Center for Pediatric Ophthalmology, Medical University of South Carolina, Charlston 29425-2236, USA.
Insights
Routine ophthalmic examinations in infants after extracorporeal membrane oxygenation (ECMO) revealed no clinically significant retinal findings. This suggests post-ECMO eye screenings may not be necessary, reducing infant stress.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Critical Care
Background:
- Ocular abnormalities can occur in infants following extracorporeal membrane oxygenation (ECMO).
- Routine ophthalmic examinations are recommended for infants undergoing ECMO.
- Previous studies suggest a potential link between ECMO and vision-threatening eye conditions.
Purpose of the Study:
- To evaluate the necessity of routine ophthalmic examinations in infants post-ECMO.
- To determine the incidence of clinically significant retinal findings in infants after ECMO.
- To assess the cost-effectiveness and impact of post-ECMO eye screenings.
Main Methods:
- Retrospective review of medical records for infants treated with ECMO.
- Analysis of ophthalmic examination data performed before or immediately after hospital discharge.
- Examinations were conducted similarly to retinopathy of prematurity screening protocols.
Main Results:
- 171 infants (342 eyes) were included in the study.
- 88% of eyes (302/342) showed normal fundus examinations.
- Abnormal retinovascular findings, when present, were not vision-threatening and required no treatment.
Conclusions:
- No clinically important retinal findings were identified in infants screened post-ECMO.
- Routine dilated fundus examinations after ECMO may not be cost-effective.
- Post-ECMO eye screenings can impose unnecessary stress on infants.
Background:
Ophthalmic examinations performed in infants undergoing extracorporeal membrane oxygenation (ECMO) are recommended because ocular abnormalities have been known to occur after this procedure.
Methods:
We reviewed medical records of infants treated with ECMO was subsequently underwent routine ophthalmic examination prior to or immediately after hospital discharge. Examinations were performed in a fashion similar to that for retinopathy of prematurity screening.
Results:
Eye examinations were recorded for 171 patients (342 eyes). Fundus examination was normal in 302 eyes (88%). Abnormal retinovascular findings such as venous dilation or intraretinal hemorrhages, when present, were not considered vision threatening and required no treatment.
Conclusion:
Clinically important retinal findings were not identified in our patients undergoing postECMO screening. Routine dilated fundus examination is probably not cost effective and places additional and potentially unnecessary stress on these infants.