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Comparison between wide-field digital imaging system and the red reflex test for universal newborn eye screening in Brazil.
da Cunha, Laura Pires; Cavalcante Costa, Marcelo Alexandre Agra; de Miranda, Homero Augusto; Reis Guimarães, Juliana; Aihara, Teruo; Ludwig, Cassie A; Rosenblatt, Tatiana; Callaway, Natalia F; Pasricha, Malini; Al-Moujahed, Ahmad; Vail, Daniel; Ji, Marco H; Kumm, Jochen; Moshfeghi, Darius M.
Afiliação
  • da Cunha LP; Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
  • Cavalcante Costa MAA; Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
  • de Miranda HA; Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
  • Reis Guimarães J; Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
  • Aihara T; Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
  • Ludwig CA; Stanford University, Byers Eye Institute, Palo Alto, CA, USA.
  • Rosenblatt T; Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
  • Callaway NF; Stanford University, Byers Eye Institute, Palo Alto, CA, USA.
  • Pasricha M; Stanford University, Byers Eye Institute, Palo Alto, CA, USA.
  • Al-Moujahed A; Stanford University, Byers Eye Institute, Palo Alto, CA, USA.
  • Vail D; Stanford University, Byers Eye Institute, Palo Alto, CA, USA.
  • Ji MH; Stanford University, Byers Eye Institute, Palo Alto, CA, USA.
  • Kumm J; Stanford University, Byers Eye Institute, Palo Alto, CA, USA.
  • Moshfeghi DM; Stanford University, Byers Eye Institute, Palo Alto, CA, USA.
Acta Ophthalmol ; 99(7): e1198-e1205, 2021 Nov.
Article em En | MEDLINE | ID: mdl-34032022
PURPOSE: To compare neonatal eye screening using the red reflex test (RRT) versus the wide-field digital imaging (WFDI) system. METHODS: Prospective cohort study. Newborns (n = 380, 760 eyes) in the Maternity Ward of Irmandade Santa Casa de Misericórdia de São Paulo hospital from May to July 2014 underwent RRT by a paediatrician and WFDI performed by the authors. Wide-field digital imaging (WFDI) images were analysed by the authors. Validity of the paediatrician's RRT was assessed by unweighted kappa [κ] statistic, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). RESULTS: While WFDI showed abnormalities in 130 eyes (17.1%), RRT was only abnormal in 13 eyes (1.7%). Wide-field digital imaging (WFDI) detected treatable retina pathology that RRT missed including hyphema, CMV retinitis, FEVR and a vitreous haemorrhage. The sensitivity of the paediatrician's RRT to detect abnormalities was poor at 0.77% (95% confidence interval, CI, 0.02%-4.21%) with a PPV of only 7.69% (95% CI, 1.08%-38.85%). Overall, there was no agreement between screening modalities (κ = -0.02, 95% CI, -0.05 to 0.01). The number needed to screen to detect ocular abnormalities using WFDI was 5.9 newborns and to detect treatable abnormalities was 76 newborns. CONCLUSION: While RRT detects gross abnormalities that preclude visualization of the retina (i.e. media opacities and very large tumours), only WFDI consistently detects subtle treatable retina and optic nerve pathology. With a higher sensitivity than the current gold standard, universal WFDI allows for early detection and management of potentially blinding ophthalmic disease missed by RRT.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Nervo Óptico / Reflexo / Retina / Triagem Neonatal / Oftalmopatias Tipo de estudo: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Female / Humans / Male / Newborn País/Região como assunto: America do sul / Brasil Idioma: En Revista: Acta Ophthalmol Assunto da revista: OFTALMOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Nervo Óptico / Reflexo / Retina / Triagem Neonatal / Oftalmopatias Tipo de estudo: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Female / Humans / Male / Newborn País/Região como assunto: America do sul / Brasil Idioma: En Revista: Acta Ophthalmol Assunto da revista: OFTALMOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido