2.1 General Information
A total of 7,239 newborns completed eye screening. They were divided into neonatal intensive care units (NICU Group) and Mother-infant ward group (Control Group). 1758 in the NICU group and 5481 in the Control Group. Basic neonatal information including sex, birth weight, gestational age, birth mode, etc., was recorded in detail in Table 1.
Table 1 General information on two groups of newborns Number (%)
Group
|
Gender
|
Birth weight
|
Mode of delivery
|
Birth weight
|
Single multiple births
|
Total
|
Male
|
Female
|
≥Week
|
< Week
|
Natural birth
|
Cesarean section
|
≥ 2 000 g
|
< 2 000 g
|
Singleton
|
Multiple birth
|
|
Control Group
|
2821
|
2660
|
5343
|
138
|
3647
|
1834
|
5443
|
38
|
5372
|
109
|
5481
|
NICU Group
|
982
|
776
|
1055
|
703
|
866
|
892
|
1449
|
309
|
1612
|
146
|
1758
|
Note: Control group = mother-child ward; NICU group = neonatal intensive care unit
2.2 Overall situation of eye abnormalities in two groups
A total of 7,239 neonatal eye screenings, 14,478 eyes and 1,200 neonatal eye abnormalities accounting for 16.58% of the total, were completed through the development of relevant screening projects and standards. A statistically significant difference between the Control Group and NICU group (P < 0.05), as shown in Table 2.
Table 2 Overall situation of two groups of neonatal eye disease screening Number (%)
Group
|
Number
|
Number of normal cases
|
Number of abnormal cases
|
χ 2
|
P
|
Control Group
|
5481
|
4481(81.75)
|
1000(18.25)
|
45.405
|
<0.01
|
NICU Group
|
1758
|
1558(88.62)
|
200(11.38)
|
Note: Control group = mother-child ward; NICU group = neonatal intensive care unit
2.3 Distribution of eye abnormalities in two groups
A total of 1,200 children with congenital eye abnormalities were found, accounted for 16.58% of the total number of newborns. Abnormalities of 1000 in 5481 cases of Control Group, accounted for 18.24% and haemorrhage 976 cases, accounted for 17.80% of the Control Group. In the 1758 cases of NICU group there were 200 cases of abnormalities which accounted for 11.37%. 165 Bleeding cases which accounted for 9.38%. The vast majority of abnormality was retinal haemorrhage. Mentoring parents to have early detection, early diagnosis and early treatments can help to shorten the course of development on eye disease with positive therapeutic significance such as retinopathy of prematurity, congenital retinoblastoma, congenital cataracts, etc. For some congenital eye abnormalities less intense therapeutic significance such as retinal degeneration, corneal leukoplasia, etc., the children's families should be informed promptly so as not to cause psychological burden and other contradictions. The detection of congenital eye abnormalities in the Control Group and NICU group is shown in Table 3.
Table 3 Abnormalities in Screening for Neonatal Eye Diseases in Two Groups Number (%)
Group Control Group
|
RH
|
ROP
|
ROP-like
|
RB
|
PHPV
|
Retinal degeneration
|
Congenital cataracts
|
Pupillary residual membrane
|
Corneal leukoplasia
|
Others
|
Total
|
Control Group
|
976
|
0
|
3
|
1
|
2
|
4
|
0
|
2
|
3
|
9
|
1000
|
NICU Group
|
165
|
19
|
3
|
1
|
1
|
2
|
2
|
0
|
0
|
7
|
200
|
Note: RH = retinal hemorrhage; ROP = retinopathy of prematurity; ROP-like = retinopathy of similar premature infants found in full-term infants; RB = congenital retinoblastoma; PHPV = persistent hyperplasia of primary vitreous; Others: albino fundus, optic papillary pigmentation, peripheral white spot, peripheral exudative retinopathy and other lesions.
2.4 Two Groups of Eye Abnormalities Prognostic and outcome
Among 1200 newborns with abnormal screening results, the most common abnormality was RH, which was eventually absorbed without any treatment. In children with ROP and ROP-like, 5 cases of them had a one-time anti-VEGF injection treatment. Another one case had a two-time anti-VEGF injection (Ranibizumab) treatment. After that the retinal spine gradually decreased and eventually subsided. In 2 cases of congenital cataract newborns, one case was transferred to an upper-level hospital for further treatment without surgery. They are under a follow-up plan. Another newborn is currently 10 months old and is in our hospital’s follow-up plan. Two cases of RB neonates were transferred to an upper-level hospital for diagnosis and care. Surgeries were completed. Among them, one case of neonatal diagnosis of binocular RB. The left eye was more severe than the right eye. After surgical treatment the left eye lost its function. The vision of the right eye was at 0.5. A higher-level hospitals recommended that regular follow-up and surgery again if necessary. In another case, RB was diagnosed in the right eye, the left eye was normal. The right eye extraction had been performed and the life of the two newborns described above was not threatened after the surgery. In addition, retinal degeneration, permanent primitive vitreous hyperplasia, pupillary residual membrane, corneal leukoplasia and other abnormalities have not been surgically treated. They are to be followed up.