[Non-ROP ophthalmological screening in the Neonatal Intensive Care Unit at the University of Szeged].

Abstract

Introduction: In accordance with the Hungarian national guideline, all newborns treated in Neonatal Intensive Care Unit (NICU) undergo an ophthalmological examination before discharge, regardless of gestational age. Objective: The aim of our study was to summarize and analyze the abnormalities observed during the ophthalmological examination of >32 -gestational-week infants and during their follow-up examinations up to 1 year of age; to determine the need of non-ROP ophthalmological examinations. Method: We retrospectively analyzed the results of ophthalmological examinations of newborns treated between 1st January 2018 and 31st December 2020 in our NICU, University of Szeged. The following data were examined: gestational age, birth weight, ophthalmologic abnormalities, number of follow ups until the age of one year. Results: During the study period, 696 neonates were treated at the NICU of University of Szeged. No data were available or no studies were carried out in 200 cases (n = 496). 160 newborn infants underwent ROP screening (≤32 gestational weeks or ≤1500 g), in 336 cases non-ROP ophthalmological examinations were performed (>32 gestational weeks or >1500 g). Out of these we considered 301 cases (89.6%) as „screening” and the rest of the examinations (35/336 [10.4%]) were clinically justified, e.g. presence of neurological symptoms, traumatic birth, clinical suspicion of genetic syndrome. The incidence of ophthalmological abnormalities were significantly higher (34.3% [12/35]) in neonates examined with clinical indications when compared to the screening group (14.6% [44/301]). While underdeveloped retinal vascular system occurred most frequently in the screening group, other abnormalities (retinal focal atrophy, optic hypoplasia of the optic nerve, morning glory papilla, coloboma, lesion due to ichthyosis, microphthalmia, chorioretinitis) were found in the clinically indicated cases. As a result of the ophthalmological screening, an average of 2.1 follow-up examinations were performed per case up to the age of 1 year. None of the found abnormalities required intervention. Conclusion: Non-ROP ophthalmological examinations performed prior to discharge from the NICU did not reveal any abnormalities requiring therapy, no ROP developed during the follow up of immature retinal vascular system. In addition to newborn physical examination red reflex testing, our results support the performance of targeted ophthalmological examinations instead of universal screening. Orv Hetil. 2025; 166(38): 1490–1495.