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Fundus examination of 199 851 newborns by digital imaging in China: a multicentre cross-sectional study
  1. He Tang1,
  2. Na Li2,
  3. Zhan Li3,
  4. Meiju Zhang4,
  5. Meirong Wei5,
  6. Changbing Huang6,
  7. Jihong Wang7,
  8. Fuxin Li8,
  9. Hong Wang9,
  10. Zijiang Liu10,
  11. Liying He11,
  12. Yangyang Cheng12,
  13. Wei Chen13,
  14. Liwen Jin14,
  15. Limin Gong1,
  16. Jun Lu2,
  17. Yan Xue3,
  18. Manxiang Su3,
  19. Yanhong Wang4,
  20. Haiming Mo5,
  21. Zhenwen Chen5,
  22. Wei Guo8,
  23. Yun Li9,
  24. Hong Pan15,
  25. Wei Zhang15,
  26. Xu Ma15,
  27. Xi Jin1,
  28. Binbin Wang15,
  29. On behalf of The collaborating group of neonatal ocular birth defects and genetic diseases in China
  1. 1 National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China
  2. 2 Department of Ophthalmology, Maternal and Children’s Hospital, Kunming, Yunnan, China
  3. 3 Department of Ophthalmology, Maternal and Children’s Hospital, Zhuhai, Guangdong, China
  4. 4 Department of Ophthalmology, Maternal and Children’s Hospital, Linyi, Shandong, China
  5. 5 Department of Ophthalmology, Maternal and Children’s Hospital, Liuzhou, Guangxi, China
  6. 6 Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
  7. 7 Department of Ophthalmology, Maternal and Children’s Hospital, Huhhot, Inner Mongolia, China
  8. 8 Department of Ophthalmology, Maternal and Children’s Hospital, Changchun, Jilin, China
  9. 9 Department of Ophthalmology, Maternal and Children’s Hospital, Maanshan, Anhui, China
  10. 10 Department of Ophthalmology, Maternal and Children’s Hospital, Urumqi, Xinjiang, China
  11. 11 Department of Ophthalmology, Chongqing Health Center for Women and Children, Chongqing, China
  12. 12 Department of Ophthalmology, Maternal and Children’s Hospital of Hunan Province, Changsha, Hunan, China
  13. 13 Department of Ophthalmology, Maternal and Children’s Hospital, Haidian district, Beijing, China
  14. 14 Departmen of Ophthalmology, Maternal and Children’s Hospital, Quanzhou, Fujian, China
  15. 15 National Research Institute for Family Planning, Beijing, China
  1. Correspondence to Mr Binbin Wang, Center for Genetics, National Research Institute for Family Planning, Beijing, China; wbbahu{at}163.com; Ms Xi Jin, , National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China; jinxi{at}chinawch.org.cn; Mr Xu Ma, Center for Genetics, National Research Institute for Family Planning, Beijing, China; Nicgr{at}263.net

Abstract

Background The 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.

Methods Fundus 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.

Results A 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.

Conclusion This 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.

  • neonates
  • fundus examination
  • digital imaging
  • ocular abnormalities
  • retinal hemorrhages

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Footnotes

  • HT, NL, ZL, MZ and MW contributed equally.

  • Contributor HT designed the multicentre investigation, analysed the data, drafted the initial manuscript and revised the manuscript. NL, Z Li, MZ and MW designed the fundus screening procedures and diagnosis criteria, took charge of quality control of fundus screening, draft and revised the manuscript. CH, JW, FL, HW, Z Liu, LH, YC, WC and LJ helped design the multicentre investigation, reviewed the fundus images and revised the manuscript. JL, YX, MS, YW, HM, ZC, WG and YL performed fundus examination, collected data at each centres and reviewed the manuscript. LG, HP and WZ designed the criteria of data collection, sample inclusion and exclusion and supervised the data collection at different centres. BW, XJ and XM conceptualised and designed the study and revised the manuscript critically. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding This work was supported by the National Science and Technology Basic Work (2014FY130100), the National Key Research and Development Program of China (2016YFC1000307) and the National Infrastructure of Chinese Genetic Resources (YCZYPT[2017]01-6).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study was approved by the ethical committee of National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention and the ethical committee of National Research Institute for Family Planning.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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