Universal eye screening: perinatal risk factors and ocular abnormalities in 1795 newborns not meeting retinopathy of prematurity criteria.

ABSTRACT

OBJECTIVES: This prospective cohort study aimed to investigate the ocular outcomes of universal eye screening in newborns and assess the relationship between different perinatal risk factors and various ocular abnormalities in infants who do not meet the criteria for retinopathy of prematurity (ROP) screening. METHODS: An universal eye screening questionnaire was utilised to screen newborn babies who did not meet the ROP screening criteria within 72 h of birth at a public and private hospital between June 2016 and April 2018. The questionnaire covered demographic characteristics, neonatal history, and eye examination findings. A trained retina specialist conducted comprehensive anterior and posterior segment examinations utilising a binocular indirect ophthalmoscope. RESULTS: Out of the 1795 newborns screened, 55.2% were male, and 44.8% were female. The most prevalent ocular abnormality observed was retinal haemorrhage (RH), with a prevalence of 10.64% (95% CI 9.25-12.16%). The prevalence of non-RH abnormality was 7.5% (95% CI 6.34-8.84%). The retinal haemorrhages were associated with normal vaginal deliveries (OR 9.91; 95% CI 6.71-14.64, p-value < 0.001), while non-RH abnormalities were associated with pre-term babies (OR 4.87; 95% CI 3.03-7.83, p < 0.001), consanguinity (OR 2.20; 95% CI 1.28-3.8, p < 0.001), low birth weight (OR 0.22; 95% CI 0.14-0.34, p < 0.001) and systemic abnormalities (OR 3.08; 95% CI 1.94-4.91, p < 0.001). CONCLUSIONS: 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 in future prospective studies.