Results Of Neonatal Eye-disease Screening And Clinical Analysis For Screening Strategy

Objective:To investigate the detection of neonatal eye diseases in local region, to discuss clinical features and relevant risk factors of neonatal eye diseases, and to explore screening standards suitable for local neonatal.Methods:8002of8335neonates(96.0%), born from Jan.2010to Nov.2010in Jinan Maternal and Child Health Care Hospital received screening. Of them698were high risk infants (hospitalized in neonatal intensive care unit, NICU).The first screening examination was done2-7days after birth. All neonates accepted eye-disease screening including light stimulation reflection, external eye examination and red light reflection. Neonates with an abnormal result, high risk newborns, and neonates with a family history of genetic eye diseases received fundus examination after mydriasis with0.5%tropicamide and0.5%epinephrine eye drops (Mydrin). Indirect ophthalmoscopy with scleral indentation was used when needed. Results of the first screening were recorded and analyzed. Correlative factors of several common eye diseases were analyzed. Logistic multiple regression was using as the detection of retinal hemorrhage and persistent hyaloid artery was supposed to be a dependent variable (detection=1, normal=0); and gestational age, birth weight, gender, delivery mode, gravidity and parity history, and Apgar’ score at1minute was supposed to be independent variables. The difference was considered to be statistically significant if P<0.05. All neonates were divided into normal and high risk groups, and the results were tested with the method of Fisher precise probability test and χ2test according to data distribution. In the end, we compared the screening results.Results:1141of8002neonates were detected to have eye diseases, with a rate of13.93%.54neonates (80eyes) were detected to have inborn eye-diseases, with a rate of0.67%. It included38cases of persistent hyaloid artery (0.48),1case of congenital microphthalmia (0.01%),4cases of congenital ptosis (0.05%),4cases of corneal opacity (0.05%),4cases of congenital cataract (0.05%),2cases of corectopia (0.02%), and1case of congenital glaucoma (0.01%).1061neonates (1487eyes) were detected to have acquired eye-diseases, with a rate of13.26%. It included336cases of acute conjunctivitis (4.20%),652cases of subconjunctival hemorrhage (8.15%),38cases of neonatal dacryocystitis (0.47%),8cases of vitreous hemorrhage (0.1%), and27cases of retinal hemorrhage (0.34%). The normal rate was60.74%in normal group, and49.71%in high risk group. High risk group had a lower normal rate than normal group (x2=32.263, p=0.000). The rate of positive sing detection in high risk group was higher than normal group. But the rate of inborn eye-diseases and acquired eye-diseases detection of both groups had no significant difference. Birth weight, delivery mode, gravidity and parity history had statistic significance in Logistic multiple regression of retinal hemorrhage. Gestational age had statistic significance in analysis of persistent hyaloid artery.Conclusion:The incidence of neonatal eye-diseases was high in perinatal and pediatrics clinic, and it was interrelated with perinatal factors. Neonates in NICU had a higher rate of ocular developmental immaturity, so eye-disease screening in neonate had much significance in clinical practices.