Neonatal Eye Screening for 203 Healthy Term Newborns Using a Wide-Field Digital Retinal Imaging System

Abstract Purpose: This study aimed to determine the proportion and types of ocular abnormalities detected in healthy term newborns and also the risk factors associated with retinal haemorrhages.Method: This cross-sectional study comprised of 203 participants, all healthy term newborn infants in the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a six months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared with similar studies previously published in the literature.Results: Total ocular abnormalities were detected in 34% infants. The most common finding was retinal haemorrhage in 29.6% infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly 3.5 times higher risk of newborns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1 minute increment in the duration of 2nd stage of labour. Conclusion: Universal eye screening for all newborns using a wide-field digital imaging system is possible, safe and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage. Although most resolve spontaneously, a longitudinal study is needed to study the long term effect of retinal haemorrhages in these infants.

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Neonatal eye screening for 203 healthy term newborns using a wide-field digital retinal imaging system

10.21203/rs.2.16561/v1 ◽

2019 ◽

Author(s):

Kenneth Teow Kheng Leong ◽

Siti Nur Amira Abu Kassim ◽

Jasvinjeet Kaur Sidhu ◽

Zayani Zohari ◽

Thivakar Sivalingam ◽

...

Keyword(s):

Imaging System ◽

Retinal Imaging ◽

Common Finding ◽

Wide Field ◽

Retinal Haemorrhage ◽

Cross Sectional ◽

Ocular Abnormalities ◽

Eye Screening ◽

Term Newborns ◽

Retinal Haemorrhages

Abstract Purpose This study aimed to determine the proportion and types of ocular abnormalities detected in healthy term newborns and also the risk factors associated with retinal haemorrhages. Method This cross-sectional study comprised of 203 participants, all healthy term newborn infants in the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a six months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared with similar studies previously published in the literature. Results Total ocular abnormalities were detected in 34% infants. The most common finding was retinal haemorrhage in 29.6% infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly four times higher risk of newborns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1 minute increment in the duration of 2nd stage of labour. Newborns delivered via SVD with episiotomy had 2.5 higher odds of developing retinal haemorrhage in newborns compared to SVD without episiotomy. Conclusion Universal eye screening for all newborns using a wide-field digital imaging system is possible, safe and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage. Although most resolve spontaneously, a longitudinal study is needed to study the long term effect of retinal haemorrhages in these infants.

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Neonatal eye screening for 203 healthy term new-borns using a wide-field digital retinal imaging system

BMC Ophthalmology ◽

10.1186/s12886-021-01882-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kenneth Teow Kheng Leong ◽

Siti Nur Amira Abu Kassim ◽

Jasvinjeet Kaur Sidhu ◽

Zayani Zohari ◽

Thivakar Sivalingam ◽

...

Keyword(s):

Imaging System ◽

Retinal Imaging ◽

Common Finding ◽

Wide Field ◽

Retinal Haemorrhage ◽

Cross Sectional ◽

Ocular Abnormalities ◽

New Born ◽

Eye Screening ◽

Eye Examination

Abstract Background The current practice for new-born eye examination by an Ophthalmologist in Malaysian hospitals is limited to only preterm new-borns, syndromic or ill infants. Healthy term new-borns are usually discharged without a thorough eye examination. This study is aimed at determining the proportion and types of ocular abnormalities detected in purportedly healthy term new-borns. Method This cross-sectional study is comprised of 203 participants, all purportedly healthy term new-born infants from the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a 6 months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared and correlated with similar studies published in the literature previously. Results Total ocular abnormalities were detected in 34% of the infants. The most common finding was retinal haemorrhage in 29.6% of the infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly 3.5 times higher risk of new-borns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1-min increment in the duration of 2nd stage of labour. Conclusion Universal eye screening for all new-borns using a wide-field digital imaging system is realistically possible, safe, and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage.

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Fundus examination of 199 851 newborns by digital imaging in China: a multicentre cross-sectional study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312366 ◽

2018 ◽

Vol 102 (12) ◽

pp. 1742-1746 ◽

Cited By ~ 2

Author(s):

He Tang ◽

Na Li ◽

Zhan Li ◽

Meiju Zhang ◽

Meirong Wei ◽

...

Keyword(s):

Digital Imaging ◽

Large Scale ◽

Imaging System ◽

Cross Sectional Study ◽

Wide Field ◽

Fundus Examination ◽

Sectional Study ◽

Cross Sectional ◽

Ocular Abnormalities ◽

Ocular Health

BackgroundThe prevalence of ocular abnormalities of newborn in China has seldom been reported. To report the implementation of digital imaging in ocular screening of all newborns in multiple centres in China and to describe the abnormal findings of fundus examination, we did the cross-sectional study.MethodsFundus examinations were performed on newborns within the 42 days after birth using a RetCam wide-field digital imaging system. Digital images of the posterior pole, superior, nasal and temporal retinal fields of each participant were taken. All newborns were from eights centres across China from January 2009 to July 2017.ResultsA total of 199 851 newborns were included in the study. We detected 18 198 (9.11%) abnormal cases. The most frequent abnormality was severe retinal haemorrhage (RH) found in 12 810 cases (6.41%). The other anomalies included familial exudative vitreoretinopathy, retinopathy of prematurity, abnormal fundus pigmentation, subconjunctival haemorrhage, choroidal coloboma, idiopathic retinal venous tortuosity, exudative changes and other anomalies with uncertain identities.ConclusionThis large-scale study of newborn fundus examination showed a relatively high prevalence of ocular abnormalities. Hundreds of neonates with rare disorders that severely impair ocular health were also detected at an early age. The long-term impact of other anomalies including RHs on the ocular system should be investigated by a perspective study. Our study suggested that fundus examination of newborns can play a beneficial role in ocular health.

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Observation of the far peripheral retina of normal eyes by ultra-wide field fluorescein angiography

European Journal of Ophthalmology ◽

10.1177/1120672120926453 ◽

2020 ◽

pp. 112067212092645

Author(s):

Xiaoling Wang ◽

A’min Xu ◽

Zuohuizi Yi ◽

Lu He ◽

Juejun Liu ◽

...

Keyword(s):

Fluorescein Angiography ◽

Imaging System ◽

Late Phase ◽

Clinical Work ◽

Cross Sectional Study ◽

Peripheral Retina ◽

Wide Field ◽

Cross Sectional ◽

Avascular Area ◽

Visual Disturbances

Purpose The appearance of the far peripheral retina in normal eyes was observed using an Optos ultra-wide field fluorescein angiography imaging system. Methods A cross-sectional study of ultra-wide field pseudocolor and angiography images obtained using the Optos 200Tx. Four different non-vascular and six vascular-associated fluorescence features in far peripheral retina were analyzed. Results A total of 166 eyes in 83 patients met the inclusion criteria. The mean patient age was 40.78 ± 10.94 years (range: 20–65 years) with a female-to-male ratio of 0.98. Slight cataract were present in 64 eyes (38.55%), low to moderate myopia in 50 eyes (30.12%), and unspecified visual disturbances in 52 eyes (31.33%). Far peripheral retinas were found to have mottled florescent band in 42.17% eyes, ground glass hyperfluorescence in 84.34% eyes, granular hyperfluorescence in 12.65% eyes, local mottled fluorescence in 10.84% eyes, vascular anastomosis with a peripheral avascular area in 36.23% eyes, invisible capillary details in 50.67% eyes, vessels passing through the ora serrata in 16.98% eyes, late-phase slight leakage in 32.53% eyes, angiectasis in 18.67% eyes, and microaneurysm in 34.94% eyes. Conclusion Ultra-wide field fluorescein angiography revealed various fluorescence features in the periphery of normal eyes, providing a basis for interpreting normal and pathological changes in peripheral retina and an important reference for clinical work.

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Prospective observational study of universal newborn eye screening in a hospital and community setting in New Zealand

BMJ Paediatrics Open ◽

10.1136/bmjpo-2018-000376 ◽

2019 ◽

Vol 3 (1) ◽

pp. bmjpo-2018-000376 ◽

Cited By ~ 3

Author(s):

Samantha Kaye Simkin ◽

Stuti L Misra ◽

Malcolm Battin ◽

Charles N J McGhee ◽

Shuan Dai

Keyword(s):

New Zealand ◽

Optic Nerve ◽

Congenital Cataract ◽

Newborn Infants ◽

Community Setting ◽

Optic Nerve Hypoplasia ◽

Wide Field ◽

Ocular Abnormalities ◽

Eye Screening ◽

Retinal Haemorrhages

ObjectiveEarly detection of ocular abnormalities in newborn infants is essential for timely diagnosis and treatment. This study aimed to assess wide-field digital imaging for universal newborn eye screening (UNES) to determine the prevalence of ocular abnormalities, including retinal haemorrhages, in newborn infants in New Zealand.DesignProspective ocular screening study of infants.SettingA public hospital maternity ward and a community birth centre in Auckland, New Zealand.PatientsA total of 350 infants were enrolled in UNES, those with birth weight <1250 g or gestational age <30 weeks were excluded.MethodsWide-field digital images of the external eye and retina were captured by RetCam (Natus Medical, San Carlos, California, USA) and reviewed by an ophthalmologist via an established telemedicine methodology.Main outcome measuresDetection of ocular abnormalities, including retinal haemorrhages. Correlation between haemorrhages and maternal, obstetric and neonatal factors.ResultsA total of 346 infants completed screening (median age 2 days). Retinal haemorrhages were present in 50 cases (14.5%), two cases exhibited persistent retinal haemorrhages at 6-week follow-up. A significant increase in the odds of retinal haemorrhages was present for vaginal delivery compared with caesarean section. Other ocular abnormalities, including congenital cataract and optic nerve hypoplasia, were present in 1.4% of infants.ConclusionsOcular abnormalities were detected by UNES including congenital cataract and optic nerve hypoplasia. However, retinal haemorrhages, significantly associated with delivery modality, were the most common abnormality detected. The majority of retinal haemorrhages resolved spontaneously.

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Retinal abnormalities in universal eye screening of healthy, full-term newborn infants in Jakarta. The incidence and its risk factors: a pilot study

International Journal of Retina and Vitreous ◽

10.1186/s40942-021-00337-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Rita S. Sitorus ◽

Indra Maharddhika Pambudy ◽

Rinawati Rohsiswatmo ◽

Julie Dewi Barliana ◽

Dian Estu Yulia ◽

...

Keyword(s):

Risk Factors ◽

Newborn Infants ◽

Retinal Hemorrhage ◽

Full Term ◽

Common Finding ◽

Wide Field ◽

Ocular Abnormalities ◽

Term Newborn ◽

Eye Screening ◽

Ocular Abnormality

Abstract Aim To screen for ocular abnormalities in healthy full-term newborn infants using wide-field digital imaging and to analyze factors associated with the findings. Methods A total of 1208 full-term newborn infants at a tertiary eye hospital (Cipto Mangunkusumo National Referral Hospital) and a district hospital in Jakarta (Koja Hospital) were enrolled to the study. All eligible newborns underwent fundus examination within 48 h after birth using the RetCam shuttle (Natus Medical Incorporated, USA). Retinal findings were documented and analyzed according to obstetric and neonatal risk factors. Results Of the 1208 newborn infants enrolled, ocular abnormalities were found in 150 infants (12.4%). Retinal hemorrhage (RH) was the most common finding (88%) in which 2.67% involved the macula, followed by chorioretinitis (4.67%). Univariate analysis showed caesarean section (C-section) (OR 0.27, 95% CI 0.18–0.41, p < 0.001) was a protective factor against RH, while prolonged labor increased the risk of developing RH (OR 1.84, 95% CI 1.24–2.72, p = 0.002). Further multivariate analysis showed similar protective association between C-section and risk of RH (OR 0.29, 95% CI 0.19–0.44, p < 0.001), while other risk factors were not. Conclusions Our study showed that universal eye screening in healthy neonates is beneficial in the early diagnosis, monitoring and treatment of ocular abnormalities such as retinal hemorrhage, chorioretinitis and retinoblastoma. Retinal hemorrhage is the most common ocular abnormality and is associated with the delivery method and the duration of labor. Universal eye screening is visual-saving and life-saving for neonates with chorioretinitis, retinoblastoma as well as other abnormalities and should be mandatory in newborn screening.

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Cardiac Manifestation among Patients with Hypothyroidism - A Cross-Sectional Study in North Karnataka

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/426 ◽

2021 ◽

Vol 8 (26) ◽

pp. 2283-2287

Author(s):

Swetha Rajshekar Lakshetty ◽

Nandini Devru

Keyword(s):

Pericardial Effusion ◽

Diastolic Dysfunction ◽

Cardiac Dysfunction ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Common Finding ◽

Low Density ◽

Sectional Study ◽

Cross Sectional

BACKGROUND Hypothyroidism is the second most common endocrinopathy next to diabetes mellitus (DM). Hypothyroidism is associated with increased cardiovascular mortality and morbidity. Cardiovascular complications are some of the most profound, reproducible and reversible clinical findings associated with thyroid disease1 . Hence this study was undertaken to assess the cardiac dysfunction among patients with hypothyroidism by electrocardiogram (ECG) and echocardiogram (ECHO) so as to provide a proper treatment guideline even among milder cases. METHODS This was a cross sectional study carried among 50 new patients of hypothyroidism who presented to Navodaya Hospital, Raichur during 2015 to 2017. They were clinically evaluated and underwent relevant investigations, including thyroid profile estimation, cardiac evaluation using ECG and 2D ECHO. RESULTS Most cases fell in the age group of 31 - 40 years. There was an overall female preponderance (76 %) over all age groups with mean age of 42.02 years. Goiter was found in 8 % of patients, bradycardia and hypertension was seen in 30 % and 22 % respectively. Central nervous system (CNS) examination revealed delayed ankle jerk in 40 % followed by hoarseness of voice in 38 % of patients. Lipid analysis showed increase of total cholesterol (TC), low density lipoprotein (LDL), very low-density lipoprotein (VLDL), triglycerides (TGL) and decrease of highdensity lipoprotein (HDL). Normal ECG was found in 26 % of patients. Bradycardia was most common finding seen in 30 % (15) of patients. 24 % (12) of patients exhibited low voltage complexes. While, 46 % cases showed normal ECHO findings. 24 % of cases presented with pericardial effusion. 18 % cases presented with diastolic dysfunction among which majority were mild. None of the cases had severe diastolic dysfunction. Only a meagre 10 % cases showed intraventricular septum (IVS) thickness. CONCLUSIONS Pericardial effusion was seen among 24 % of patients while diastolic dysfunction was seen in 18 % patients. Thus, any unexplained pericardial effusion should be screened for hypothyroidism. KEYWORDS Hypothyroidism, Cardiac Dysfunction, 2D ECHO, ECG, Thyroid Stimulating Hormone (TSH)

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Prevalence of septal deviation in newborns: an institutional based cross sectional study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200556 ◽

2020 ◽

Vol 6 (3) ◽

pp. 481

Author(s):

Deep Jyoti ◽

Pallvi Sharma ◽

Ashu Jamwal ◽

Arti .

Keyword(s):

Nasal Septum ◽

Later Life ◽

Cross Sectional Study ◽

Common Finding ◽

Common Condition ◽

Sectional Study ◽

Routine Examination ◽

Deviated Nasal Septum ◽

Cross Sectional ◽

Factors Affecting

Background: Deviated nasal septum (DNS) is a common condition with various factors affecting its occurrence. The study was aimed to find the prevalence of DNS in newborns.Methods: The present study was a cross sectional study conducted in the SMGS hospital, GMC Jammu. A sample size of 200 newborns, less than 7 days of age were included in the study. 200 newborns in the postnatal wards were examined in the present cross-section observational study including the age ranging from 1 day to 5 days. Results: Prevalence of DNS in the present study was 29%. 103 babies were born to the primipara mothers out of which 39 (37.86%) had DNS while only 19 (19.58%) out of 97 babies born to the multipara mothers had the DNS. The newborns with higher birth weight had higher incidence of having DNS. 41.17% of the newborns with weight of >3 kg had DNS as compared to those in 2 to 2.5 kg group (17.28%) and <2 kg group (11.76%).Conclusions: DNS is a common finding since birth which may persist in later life. Routine examination of the newborns specifically regarding the nose should be done to detect the septal deviations at earliest so that active intervention can be done when required.

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An Audit of Indications for Hysterectomy in a District Hospital, Madikeri

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/45242.14167 ◽

2020 ◽

Author(s):

Sumanashree Mallappa ◽

Aishwarya Ramanujam ◽

Priyadarshini Monnappa ◽

Padmaja Kulkarni

Keyword(s):

District Hospital ◽

Cross Sectional Study ◽

Common Type ◽

Common Finding ◽

Histopathological Diagnosis ◽

Fallopian Tubes ◽

Cross Sectional ◽

Histopathological Findings ◽

Abdominal Approach ◽

Nonsurgical Management

Introduction: Hysterectomy is the removal of the uterus and is the most common gynaecological operation done in females worldwide. In the early 20th century, hysterectomies were done for many conditions like leiomyoma, Dysfunctional Uterine Bleeding (DUB), chronic pelvic pain, endometriosis, adenomyosis, prolapse, and malignancies. Considering that the procedure has a 20-35% life risk, it calls for a thorough justification before consideration. A hysterectomy has mental, physical, social, economic and psychosexual impact, apart from intraoperative and postoperative complications. Thus, an audit on hysterectomies was done to help students, medical fraternity, and the women of Kodagu in having a better understanding of hysterectomies. Aim: To conduct an audit on hysterectomies performed for gynaecological indications to correlate pre-operative diagnosis with the histopathological diagnosis. Materials and Methods: This was a cross-sectional study which included all elective hysterectomies performed for gynaecological indications conducted at the District Hospital of Kodagu Institute of Medical Sciences, Madikeri from January 2018-June 2019. All cases of hysterectomies were considered except Caesarean peripartal hysterectomies. The histopathological findings of the endometrium, myometrium, cervix, ovaries and fallopian tubes were recorded. Findings were tabulated as frequency and percentage. Then, using the data, preoperative indications were compared with postoperative histopathological findings to know if hysterectomy was justified. Results: A total of 238 hysterectomies were performed during 18 months in the District Hospital. Abdominal and vaginal approaches were used. Panhysterectomy via abdominal approach was the most common type of hysterectomy. The most common age group where hysterectomy occurred was 41-60 years. The most common indication for hysterectomy was found to be Fibroid uterus. Analysis of the myometrial findings revealed that the most common finding was leiomyoma. Majority of ovaries and fallopian tubes did not show significant pathology. Conclusion: Panhysterectomy was the most common type of hysterectomy. Fibroid were the most common histopathological findings and medium and small sized fibroids can be given a trial of nonsurgical management. Injudicious use of hysterectomy procedure has multiple loop holes involving medical fraternity, socioeconomic conditions of women and attitude of society towards female reproductive health.

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Lumbosacral transitional vertebra in military aviation candidates: A cross-sectional study

Indian Journal of Aerospace Medicine ◽

10.25259/ijasm_50_2020 ◽

2021 ◽

Vol 65 ◽

pp. 29-32

Author(s):

R Vaidya ◽

M Bhatia

Keyword(s):

Armed Forces ◽

Cross Sectional Study ◽

Common Finding ◽

Small Subset ◽

Lumbosacral Junction ◽

Cross Sectional ◽

Transitional Vertebra ◽

Medical Evaluation ◽

Study Population ◽

Lumbosacral Transitional Vertebra

Introduction: Lumbosacral transitional vertebra (LSTV) is a common anomaly of the lumbosacral junction with a prevalence of 4–35.9% in various studies. Plain radiography of the spine in anteroposterior and lateral projections is done for the evaluation of the spine in candidates coming for medical evaluation for flying duties in the armed forces. Material and Methods: An observational study was conducted on the whole spine series of radiographs done at a medical selection establishment. The study population included candidates reporting to the establishment for medical examination to ascertain fitness for flying duties. In a small subset of this study population having LSTV, the Ferguson’s view was done to better delineate the lumbosacral junction. Results: The analysis revealed a total 148 cases of LSTV with a prevalence of 13.9%. Ferguson’s view, undertaken among 30 doubtful cases, confirmed the presence of LSTV in 27 cases. Type IIa was observed to be the most common pattern of LSTV followed by Type IIIb. As per the existing policy, 63.8% of candidates with LSTV were considered unfit for flying duties. Conclusion: Flying duties in the armed forces require the highest standard of physical fitness. LSTV is a very common finding during the evaluation of candidates and it is appropriate that the cases of LSTV be evaluated thoroughly. In doubtful cases of LSTV, the Ferguson’s view is a useful supplementary view as it clearly delineates the lumbosacral junction.

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