Universal Eye Screening: Perinatal Risk Factors & Ocular Pathologies in 1795 Newborns Not Meeting Retinopathy of Prematurity Criteria

Abstract Objectives: This prospective cohort study aimed to investigate the ocular outcomes of universal eye screening in newborns and assess the relationship between different perinatal risk factors and various ocular pathologies in infants who do not meet the criteria for retinopathy of prematurity (ROP) screening. Methods: A universal eye screening questionnaire was utilised to screen newborn babies who did not meet the ROP screening criteria within 72 hours of birth at a public and private hospital between June 2016 to April 2018. The questionnaire covered demographic characteristics, neonatal history, and eye examination findings. A trained retina specialist conducted comprehensive anterior and posterior segment examinations utilising a binocular indirect ophthalmoscope. Results: Out of the 1795 newborns screened, 55.2% were male, and 44.8% were female. The most prevalent ocular pathology observed was retinal haemorrhage (RH), with a prevalence of 10.64% (95% CI: 9.25% – 12.16%). The prevalence of non-RH pathology was 7.5% (95% CI: 6.34% – 8.84%). Multivariable analysis revealed that RH was associated with normal vaginal deliveries (OR: 10.1; 95% CI: 6.9-15), while non-RH pathologies were associated with preterm birth (OR: 5.6; 95% CI: 3.5-9.0), consanguinity (OR: 2.3; 95% CI: 1.3-4.1), low birth weight (OR: 8.8; 95% CI: 5.1-15.1), and systemic abnormalities (OR: 3.3; 95% CI: 2.0-5.3). Conclusions: Sight-threatening ocular pathology in newborns may be linked to perinatal risk factors such as preterm birth, low birth weight, consanguinity, and systemic abnormalities. Therefore, targeted eye screening for newborns in this high-risk group is warranted.