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Digital eye fundus triage neonates project: the near future

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First Author: H.Dietrich BRAZIL

Co Author(s):    T. Peto   P. Cagliari   J. Dietrich              

Abstract Details

Purpose:

The aim of this study is to identify the prevalence of ocular abnormalities in all newborns and highlight the importance of early eye fundus imaging. The digital triage with a portable ophthalmic camera without touching the eye could be the future for universal newborn examination, since it is an helpful tool for objective documentation of retinal findings and improves diagnostic accuracy. In addition to this, it provides objective data by reducing subjectivity and potentially minimizes human error Digital retinal imaging may also be useful for teaching staff and parents about possible results.

Setting:

Thirty-four neonates were examined at the Darcy Vargas Maternity Hospital in Joinville, SC Brazil from October 2016 through March 2017.

Methods:

Pictor Plus portable ophthalmic camera, model VP2RET manufactured by Volk (Volk Optical, Inc., Mentor, OH) was utilized. In order to reduce discomfort during examination, a 25% oral glucose solution was administered(12). As the neonates in this study had been previously screened with indirect ophthalmoscopy for peripheral retina examination, their pupils were previously dilated (tropicamide 0.5%, phenylephrine 2.5%).However, for imaging examination with Pictor Plus, pupil dilation is not required.

Results:

All newborns evaluated had normal red reflex test. Nineteen neonates (55.9%) presented with normal results and fifteen (44.1%) neonates presented with unilateral or bilateral abnormalities. Hemorrhage, retinopathy of prematurity (ROP) and toxoplasmosis had a prevalence of 13.3% each. 26.7% presented syphilis alterations and 33.3% optic disc variations. These numbers are shown in Figure 1.

Conclusions:

There is a high level of evidence demonstrating that the digital eye exam has high accuracy for alterations of newborns eyes detection. It also enabled performing examination without sedation therefore reducing the incidence of complications such as eyelid trauma, corneal ulcers, hypoventilation and bradycardia. Additionally, the use of the Pictor Plus camera, which may be performed by trained nurses, may enable the setting of a permanent data bank for clinical follow ups of possible alterations.

Financial Disclosure:

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