Early detection of ocular abnormalities in a Chinese multicentre neonatal eye screening programme—1‐year result

Abstract

Purpose: Early detection of ocular abnormalities in newborns is essential for timely diagnosis and treatment. This study aimed to assess the 1-year result of a multicentre prospective neonatal eye examination programme with wide-field digital imaging system in China. Methods: A multicentre collaborative prospective study group for neonatal eye screening was established in nine hospitals, including eight Maternal and Children's Hospitals, and one general hospital across China from July 2016 to June 2017. Ocular examinations were performed on newborns within 28 days after birth using a wide-field digital imaging system. Data were reviewed and analysed. The primary outcome was the prevalence of ocular abnormalities in neonates. Results: We detected 13 514 (20.91%) abnormal cases in 64 632 newborns. The most frequent abnormality was retinal haemorrhage (RH; 11.83%). Most of mild RH resolved spontaneously. Among those who were beyond retinopathy of prematurity (ROP) screening criteria of China (gestational age ≥32 w and birthweight ≥2000 g), the total number of neonates with ocular abnormality was 12 218/62 799(19.45%). 59.44% of neonatal ocular abnormalities detected (accounting for 11.56% of all the screened population) needed further interference or observation. Among them, 258 patients (0.41% of all the screened population) needed immediate or timely intervention, including congenital cataract, retinal detachment, retinoblastoma and other ocular abnormalities. One thousand and ninety-eight patients (1.75% of all the screened neonates) should be followed up closely and needed further diagnosis or intervention if necessary, such as ROP or ROP-like retinopathy, familial exudative vitreoretinopathy and persistent hyperplasia of primary vitreous. Five thousand nine hundred and six patients (9.4%) with minor clinical significance needed short-term follow-up. Conclusions: This prospective multicentre study of newborn ocular examination showed a relatively high prevalence of ocular abnormalities. There are a relatively high percentage of congenital eye pathology that required further referral and treatment in those neonates who were not screened routinely. According to the benefits and risks associated with neonatal eye examinations, neonatal ocular screening programme can detect ocular abnormalities at the very early stage and may play a positive role in promoting paediatric eye health.

Analysis of differences in screening results of neonatal ophthalmopathy between Neonatal Intensive Care Unit and Mother-infant Room Ward

“…Among them the highest rate was retinal hemorrhage (RH) which accounted for 95.08% of all abnormalities. The results are basically consistent with those of Zhao Peiquan [1] . We found that the main reason why the overall ocular abnormality rate was lower in the NICU group (11.37%) than in the Control Group (18.24%) was that the positive rate of retinal bleeding (9.38%) was lower in NICU group than in the Control Group (17.80%).…”

“…Early, accurate and comprehensive eye examination of newborns is a crucial step in prevention and treatment of blindness in children's vision care and in the society as a whole. Facilitating timely and effective intervention in all types of eye diseases in newborns within the optimal time window plays a key role in the physical and mental health of newborns [1] . Digital Wide Area Fundus Imaging System (RetCam 3 ) is well imaged, easy to operate and can record the eye situation objectively and accurately.…”

CTNND1 variants cause familial exudative vitreoretinopathy through the Wnt/cadherin axis

“…Familial exudative vitreoretinopathy (FEVR) is a severe genetic disorder in which incomplete peripheral retina vascularization causes secondary complications, including neovascularization, vitreous hemorrhage, retinal folds, and retinal detachments (5). A survey of early ocular examinations conducted in 64,632 Chinese newborns within 9 hospitals unraveled an incidence rate of FEVR of approximately 4.4‰ (6). Among the known genes involved in FEVR, components of the Wnt signaling pathway are highly prevalent, including FZD4 (frizzled 4) (7), LRP5 (low-density lipoprotein receptor-related protein 5) (8,9), TSPAN12 (tetraspanin 12) (10)(11)(12), NDP (norrin, previously known as Norrie disease pseudoglioma) (13), LRP6 (low-density lipoprotein receptor-related protein 6) (14), and CTNNB1 (catenin beta 1) (15)(16)(17).…”

Portable wide-field digital imaging for screening of neonatal visual impairment causes in Rio de Janeiro, Brazil: a budget impact analysis

“…Several large studies have demonstrated the results of universal neonatal eye screening. Although the majority of findings were retinal haemorrhages, some babies who would not be screened routinely required further referral and treatment 19–22. Wide-field neonatal anterior and posterior eye imaging performed by a non-ophthalmologist and immediate image referral and analysis by an ophthalmologist in a tertiary centre might contribute to early diagnosis and increase coverage 23…”