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Retinopathy of Prematurity (ROP) is a vision-threatening retinal disease found in premature babies, where early diagnosis is very important to prevent irreversible vision loss. In recent years, several studies have been conducted on the development of reliable AI-based screening systems. However, due to the lack of well-annotated public datasets most of them have been limited to experimental research, using single-central datasets. In this study, we introduce Macretina , a comprehensive and expert-annotated dataset curated from 1432 retinal fundus images of 112 premature babies collected at Macretina Hospital, Indore, India. These images were captured using the 3nethra Neo wide-field retinal imaging system, commonly used for retinopathy of prematurity (ROP) screening. The dataset is specially designed to support AI-based automated ROP diagnosis and is organized into three subsets, each addressing a distinct pathologically relevant retinal feature for ROP screening. The three subsets are: Macretina-Ridge which supports binary classification for ridge/demarcation line detection, Macretina-OD which supports object detection for optic disc localization, and Macretina-BV which supports semantic segmentation for blood vessel analysis. We also evaluated the utility of each subset using standard Deep Convolutional Neural Networks (DCNNs), and the experiments achieved promising results across Classification, Object Detection, and Segmentation tasks. Our dataset captures a wide range of disease severity and imaging variations, making it well-suited for developing clinically relevant and generalizable AI models.

To analyze the results and trends of common eye diseases from full-term neonatal eye screenings conducted between 2016 and 2023. A retrospective study was conducted on 17,378 full-term neonates screened for eye diseases at CiXi Maternity&Child Health Care Hospital from January 2016 to December 2023. Statistical analysis and Joinpoint regression were used to assess trends in eye disease incidence, measured by the Average Annual Percent Change (AAPC). Among 17,378 full-term neonates, 5,986 (34.45%) had abnormal eye screening results: Retinal hemorrhage (3,274 cases, 18.84%), white spots (1,440 cases, 8.29%), exudates (943 cases, 5.43%), pigment abnormalities (437 cases, 2.51%), and lesions resembling Familial Exudative Vitreoretinopathy (FEVR-like) (228 cases, 1.31%). Retinal hemorrhage (χ² = 1840.390, P = 0.000) and exudates (χ² = 10.488, P = 0.001) were more common in neonates born via vaginal delivery. From 2016 to 2023, the overall abnormality rate declined (AAPC = -6.9%, 95% CI: -12.1% to -1.5%, P = 0.0211). Trends included: Retinal hemorrhage (AAPC = -3.2%, 95% CI: -6.4% to 0.0%, P = 0.0499) and pigment abnormalities (AAPC = -25.4%, 95% CI: -42.8% to -3.0%, P = 0.0342). Other retinal abnormalities showed no significant trends (all P > 0.05). Eye disease due to fundus lesions From 2016 to 2023, The overall incidence of fundus lesions in full-term neonates showed a declining trend. Vaginal delivery is a risk factor for retinal hemorrhages and retinal exudation in full-term neonates. We found a strong association between cytomegalovirus infection and retinal exudation.

Background/AimsPrematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights.MethodsData, including infants born at 24–30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6–14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions.ResultsROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6–14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%.ConclusionsDIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24–30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting.

Background Preterm infants are at risk of complications due to their prematurity and Retinopathy of Prematurity (ROP) is one of them. To discover and treat ROP the preterm infants regularly undergo eye examinations. Nurses are responsible for the infants’ care during this painful and stressful procedure. Aim The aim of this study was to explore nurses’ perceptions of preterm infants’ eye examinations. Methods Data were collected through semi-structured interviews with 10 nurses experienced in participating in preterm infants’ eye examinations. Data were analysed using a phenomenographic approach. Results The results showed several perceptions of the eye examinations, and the analysis resulted in four descriptive categories: Infants are affected by the eye examination ; Nurses have comprehensive overall responsibility for the infants ; Parents are important to their infants , but they need support to fulfil their parental role , and Collaboration is important for the examination’s favourable outcome. The category Nurses have comprehensive overall responsibility for the infants was regarded as the most comprehensive, covering all the other categories. Conclusions Nurses felt a great responsibility during a painful and stressful procedure for preterm infants. Infants’ well-being could be better protected by interprofessional collaboration, improved nursing care and involved parents.

Purpose: To evaluate the demographic profile of premature infants presenting with stage 4B and stage 5 retinopathy of prematurity (ROP) at a tertiary referral center in South India. Methods: This was a retrospective review including all premature infants with stage 4B and 5 ROP between January 1, 2015 and December 31, 2022. Parameters included the newborns born at the tertiary care nursery of various institutes, gestational age, birth weight, age at presentation to the hospital, risk factors, screening details, neonatal intensive care unit details, reason for consultation, and timing of referral to the center. Results: Two hundred twenty eyes of 110 premature infants were included. Of 110 infants, 6 were born within the same city and 104 were from other districts or states. Mean birth weight was 1,125 ± 360 g and mean gestational age at birth was 28 ± 2 weeks. Mean age was 42 ± 82 weeks and median age at presentation was 17 weeks (range: 2.86 to 591 weeks). Male-to-female infant ratio was 1.34:1. Fifty (45.4%) infants had bilateral stage 5 ROP, 17 (15.4%) had stage 5 in one eye and stage 4B in the other eye, 15 (13.6%) had bilateral stage 4B and 23 (20.9%) had stage 4B in one eye and stage 4A/stage 3 in the other eye. Five (4.5%) had stage 5 in one eye and vitreous hemorrhage/stage 4A in the other eye. Among those with bilateral stage 5 ROP, 90% were from neighboring districts/states. Fifty-two (47.27%) infants underwent vitreoretinal surgery. Of 110 infants, 28 (25.45%) were self-referred (late presentation due to family-related issues), 80 (72.73%) were referred by ophthalmologists either after a few sessions of late screening or for further management, 1 (0.91%) was referred through telescreening, and 1 was referred from pediatricians directly to the hospital. Conclusions: This study highlights the importance of awareness of the disease and screening of premature infants. Lack of these two factors leads to late presentation of these infants with advanced stages and serious implications. [J Pediatr Ophthalmol Strabismus. 2024;61(5):339–343.]

Background/objectives The objective of this study was to ascertain the prevalence of ROP and other ocular diseases in late preterm infants and to evaluate the necessity of routine ROP examination in a tertiary hospital in Turkey. Subjects/methods This retrospective cohort study included late preterm infants treated in the neonatal intensive care unit (NICU) and referred to the ROP outpatient clinic. Those who were discharged or died before the first screening and those who did not complete all screening sessions were excluded. The data set comprised demographic information, gestational age, birth weight, stages of ROP, treatments, and the presence of other ocular comorbidities. Results The study cohort comprised 600 late preterm infants, with a median gestational age of 35 weeks and a mean birth weight of 2392 ± 451 g. Of the infants included in the study, 3.3% developed ROP, with one infant requiring treatment. Furthermore, 4.8% of the subjects exhibited additional ocular comorbidities. The results indicated a statistically significant correlation between lower birth weight and gestational age with an increased prevalence of ROP and other ocular pathologies. Conclusions ROP incidence in late preterm infants is relatively low, although comorbidities are notable. Infants born late preterm with lower birth weight and gestational age are at greater risk for ROP and additional pathologies. It is recommended that routine screening for ROP be conducted in order to ensure that ROP and other ocular conditions are diagnosed and treated in a timely manner, thus preventing severe visual impairments.

Aim To estimate the prevalence of retinopathy of prematurity (ROP) and investigate the prediction and validity of WINROP (Weight, Insulin-Like Growth Factor-1, Neonatal Retinopathy of Prematurity), an online monitoring algorithm in preterm infants at an African low/medium income country (LMIC) based neonatal intensive care unit (NICU). Methods Data from the ROP screening proforma for preterm infants between January 2020 and December 31, 2022, with gestational age (GA) from 24 to 32 weeks were entered into the WINROP algorithm system which signals an ROP risk alarm based on weekly weight gain and was compared with ophthalmology examination findings. Sensitivity, specificity, negative and positive predictive values were calculated, and statistical analysis was performed using EPI INFO (version 7.2.2.6). Results There were 168 preterm infants that met WINROP criteria. The median birth weight was 1380 g (IQR: 1141–1570 g), ranging from 600 g to 2100 g, while the median gestational age at birth was 31 weeks (IQR: 29.0–32.0 weeks), with a range of 24 to 32 weeks The overall prevalence of any ROP was 38.1% (64/168), type 1 ROP and type 2 ROP were 7.1% (12/168) and 8.9% (15/168) respectively. WINROP alarmed in 73 infants born at a gestational age (29.0 weeks, IQR: 28.0–31) and birth weight (1100 g, IQR: 912.5–1200 g). The specificity of WINROP for any ROP was 80.8% (84/104); the sensitivities for type 1 ROP and type 2 ROP were 91.7% (11/12) and 86.7% (13/15) respectively. The negative and positive predictive values were 88.4% (84/95) and 72.6% (53/73) respectively. Conclusion Overall, the WINROP algorithm identified 91.7% of preterm infants who had been diagnosed and treated for type 1 ROP. Though it led to a high number of false alarms, especially in the most vulnerable infants. The algorithm’s utility is likely greatest for the larger, more mature preterm infants. This confirms its usefulness to significantly reduce the number of preterm infants who need to go through stressful eye examinations in an African NICU setting where inadequate number of specialists is a major challenge.

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 abnormalities in infants who do not meet the criteria for retinopathy of prematurity (ROP) screening. Methods An universal eye screening questionnaire was utilised to screen newborn babies who did not meet the ROP screening criteria within 72 h of birth at a public and private hospital between June 2016 and 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 abnormality observed was retinal haemorrhage (RH), with a prevalence of 10.64% (95% CI: 9.25–12.16%). The prevalence of non-RH abnormality was 7.5% (95% CI: 6.34–8.84%). The retinal haemorrhages were associated with normal vaginal deliveries (OR: 9.91; 95% CI: 6.71–14.64, p -value < 0.001), while non-RH abnormalities were associated with pre-term babies (OR: 4.87; 95% CI: 3.03–7.83, p  < 0.001), consanguinity (OR: 2.20; 95% CI: 1.28–3.8, p  < 0.001), low birth weight (OR: 0.22; 95% CI: 0.14–0.34, p  < 0.001) and systemic abnormalities (OR: 3.08; 95% CI: 1.94–4.91, p  < 0.001). 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. Accordingly, it may be prudent to consider specialized ocular screening protocols for neonates within this high-risk cohort in future prospective studies.

Objective To document the findings of a newborn eye examination programme for detecting ocular pathology in the healthy full-term newborn. Methods This is a cross-sectional study of the majority of newborns born in the Kunming Maternal and Child Healthcare Hospital, China, between May 2010 and June 2011. Infants underwent ocular examination within 42 days after birth using a flashlight, retinoscope, hand-held slit lamp microscope and wide-angle digital retinal image acquisition system. The retinal fundus examination utilised the RetCam wide-field digital imaging system (Clarity Medical Systems, Pleasanton, California, USA). The external eye, pupillary light reflex, red reflex, opacity of refractive media, anterior chamber and posterior segments were also examined. Results A total of 3573 healthy full-term newborns were enrolled and examined in the programme. There was detection of 871 abnormal cases (24.4%). The majority of abnormal exams were 769 (21.52%) retinal haemorrhages. Of these, there were 215 cases of significant retinal haemorrhage, possible sight threatening or amblyogenic, representing 6.02% of the total. In addition, 67 cases (1.88%) involved macular haemorrhage. The other 107 cases (2.99%) with abnormal ocular findings included subconjunctival haemorrhage, congenital microphthalmos, congenital corneal leukoma, posterior synechia, persistent pupillary membrane, congenital cataract, enlarged C/D ratio, retinal hamartoma versus retinoblastoma, optic nerve defects, macular pigment disorder and non-specific peripheral retinopathy. Conclusion Ocular examination of healthy newborns leads to the detection of a significant number of ocular pathologies. The most commonly discovered ocular abnormality during examination of the newborns in this study is retinal haemorrhage. The long-term impact of these findings is unknown. Although presumed by some to benign, neonatal retinal haemorrhages due to birth trauma could be involved in altering visual development. Further work, including prospective examination of newborns with long-term follow-up, is needed and supported by our findings.