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Topline: A comprehensive study on universal eye screening in newborns has uncovered significant findings, revealing that 10.64% of babies exhibit retinal hemorrhage and 7.5% show other ocular abnormalities. The research identifies potential risk factors such as premature birth, consanguinity, and systemic abnormalities.
Methodology: Researchers conducted a prospective cohort study at two urban centers in Andhra Pradesh, India, from June 2016 to April 2018. The study involved 1795 newborns, with an average age of 2.67 days at their first eye screening. These infants did not meet the criteria for retinopathy of prematurity screening, which typically applies to those with a birth weight under 2000 grams or a gestational age younger than 34 weeks.
The study utilized a questionnaire on universal eye screening to gather demographic data, neonatal history, and findings from eye examinations performed within 72 hours of birth. Comprehensive examinations of the anterior and posterior segments were conducted by a trained retina specialist using an ophthalmoscope with binocular indirect viewing. Newborns identified with ocular abnormalities were referred for further evaluation and management, while those without abnormalities were reviewed after three months.
Takeaway: Retinal hemorrhage emerged as the most prevalent ocular abnormality, found in 10.64% of newborns (95% CI, 9.25-12.16). Other ocular abnormalities were detected in 7.5% of newborns (95% CI, 6.34-8.84). Newborns with retinal hemorrhage were more likely to have been delivered vaginally rather than by cesarean or forceps delivery (odds ratio [OR], 9.91; 95% CI, 6.71-14.64). Risk factors for abnormalities other than retinal hemorrhage included premature birth (OR, 4.87; 95% CI, 3.03-7.83), consanguinity (OR, 2.20; 95% CI, 1.28-3.8), and systemic abnormalities (OR, 3.08; 95% CI, 1.94-4.91).
In Practice: “Sight-threatening ocular pathology in newborns may be linked to perinatal risk factors such as preterm birth, low birth weight, consanguinity, and systemic abnormalities. Accordingly, it may be prudent to consider specialized ocular screening protocols for neonates within this high-risk cohort,” the authors wrote.
Source: The study, led by Sameera Nayak of L V Prasad Eye Institute in Vijayawada, India, was published online on July 6, 2024, in the journal Eye.
Limitations: The study’s exploratory nature and small number of elderly parents undergoing assisted vaginal delivery limited risk factor analysis. Some newborns were examined after 72 hours of birth due to logistical issues, potentially altering the birth prevalence and severity of retinal hemorrhage and other pathologies.
Disclosures: The research was supported by grants from the US Agency for International Development, Lions Clubs International Foundation, Sun Pharma, and Hyderabad Eye Research Foundation. The authors declared no conflicts of interest.
