Journal List > J Korean Ophthalmol Soc > v.56(10) > 1010119

Park and Kim: Findings of Eye Screening Examinations with Wide-Field Digital Imaging System in Healthy Newborns

Abstract

Purpose

To present the results of eye screening examinations using RetCam in healthy newborns.

Methods

Eye screening examinations were performed using the RetCam wide-field digital imaging system (Clarity Medical System, Pleasanton, CA, USA), as requested by parents, on healthy newborns within a week after birth in an obstetrics and gy-necology hospital between June 2012 and September 2014. During the examination, photographs were taken showing red re-flex and the fundus. The reading was conducted by a pediatric ophthalmologist.

Results

The examinations included a total of 10,023 newborn babies, and abnormalities were discovered in 2,916 patients (29.09%). The most commonly found abnormality was retinal hemorrhage, which was discovered in 2,796 babies (27.89%) and 471 patients showed a large amount of bleeding or macular hemorrhage. In 71 patients (0.7%), ophthalmologic examination was recommended after newborns presented with one of the following conditions: congenital cataracts, retinoblastoma, persistent hyperplastic primary vitreous, vitreous hemorrhaging, persistent pupillary membrane, choroidal nevus or albinism. Due to un-clear photographs, 85 eyes of 49 patients (0.48%) could not be read.

Conclusions

Ophthalmologic screening using RetCam is a safe, simple and useful technique for discovering ophthalmologic abnormalities. Additionally, when abnormalities are suspected, the role of a pediatric ophthalmologist is increasingly important in helping patients receive appropriate ophthalmologic treatment. Furthermore, retinal hemorrhage, which occurred in the majority of all observed abnormalities, requires further investigation to examine the possibilities of amblyopia in cases with a large amount of bleeding or macula involvement.

References

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Figure 1.
Retinal hemorrhages found on a newborn digital eye examination. (A) Submacular hemorrhage (white arrow). (B) Multiple retinal hemorrhages (black arrows) around the optic disc. (C) Severe retinal hemorrhages. (D) Severe retinal hemorrhages with vitreous hemorrhage.
jkos-56-1617f1.tif
Figure 2.
Other retinal findings found on newborn digital eye examination. (A) Choroidal nevus (white arrow). (B) Albinism. (C) Persistent hyperplastic primary vitreous. (D) Coloboma (black arrowheads). (E) Macular and subretinal hemorrhage (white arrows) with abnormal retinal venous beading toward the macular (white arrowheads). (F) Retinoblastima (white arrow).
jkos-56-1617f2.tif
Figure 3.
Abnormal findings in anterior segment examination. (A) Congenital cataract. (B) Persistent pupillary membrane.
jkos-56-1617f3.tif
Table 1.
Characteristics of the participating newborns
Variable Values
Number of patients 10,023
Mean gestational age (weeks) 39 ± 1
Sex (male:female) 5,395:4,628 (1.16:1)
Method of delivery (NSVD:C/S) 5,283:4,740 (1.11:1)
Mean birth weight (gram) 3,220.30 ± 426.15

Values are presented as mean ± SD or number. NSVD = normal spontaneous vaginal delivery; C/S = cesarean section.

Table 2.
Eye abnormalities found in healthy newborns (n = 10,023 newborns)
Abnormalities Number of patients Proportions (%)
Retinal hemorrhage 2,796 27.89
Media opacity of unknown origin 35 0.35
Optic disc abnormality (ex. coloboma, hemorrhages, high C/D ra atio) 10 0.1
Vitreous opacity 4 0.04
Choroidal nevus 4 0.04
Congenital cataract 4 0.04
Albinism 4 0.04
Retinoblastoma 3 0.03
Retinal hypopigmentation 3 0.03
Vitreoretinopathy (ex. PHPV, ROP) 2 0.02
Persistent pupillary membrane 1 0.01
Congenital keratoleucoma 1 0.01
Total 2,867 28.60

C/D = cup/disc ratio; PHPV = persistent hyperplastic primary vitreous; ROP = retinopathy of prematurity.

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