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

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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.

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Fig. 1: The spectrum of ocular pathology detected during UESN.

Data availability

The data supporting this study’s findings are available on request to IRB (irb@lvpei.org) along with cc to the corresponding author, RK (rohit@lvpei.org). The data are not publicly available because they contain information that could compromise the privacy of research participants.

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Funding

United States Agency for International Development (USAID), USA; Lions Clubs International Foundation, USA; Sun Pharma, India and Hyderabad Eye Research Foundation, Hyderabad, India.

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Authors and Affiliations

  1. Anant Bajaj Retina Institute, L V Prasad Eye Institute (Kode Venkatadri Chowdary Campus), Vijayawada, Andhra Pradesh, India

    Sameera Nayak

  2. David Brown Children Eye Care Centre (DBCECC), L V Prasad Eye Institute (Kode Venkatadri Chowdary Campus), Vijayawada, Andhra Pradesh, India

    Sameera Nayak

  3. Anant Bajaj Retina Institute, L V Prasad Eye Institute (Mithu Tulsi Chanrai Campus), Bhubaneswar, Odisha, India

    Tapas Ranjan Padhi

  4. Miriam Hyman Children’s Eye Care Centre (MHCECC), L V Prasad Eye Institute (MithuTulsi Chanrai Campus), Bhubaneswar, Odisha, India

    Tapas Ranjan Padhi

  5. Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, Telangana, India

    Asha Latha Mettla & Rohit C. Khanna

  6. School of Optometry and Vision Science, University of New South Wales, Sydney, Australia

    Asha Latha Mettla & Rohit C. Khanna

  7. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India

    Rohit C. Khanna

  8. University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA

    Rohit C. Khanna

Authors
  1. Sameera Nayak
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  2. Tapas Ranjan Padhi
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  3. Asha Latha Mettla
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  4. Rohit C. Khanna
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Correspondence to Rohit C. Khanna.

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Nayak, S., Padhi, T.R., Mettla, A.L. et al. Universal eye screening: perinatal risk factors and ocular abnormalities in 1795 newborns not meeting retinopathy of prematurity criteria. Eye (2024). https://doi.org/10.1038/s41433-024-03162-6

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