[Retinopathy in premature infants. Present value of surveillance of premature and newborn infants at risk]

Abstract

Systematic ophthalmologic screening of infants in a Neonatal Intensive Care Unit is time consuming and sometimes difficult. In this retrospective study of 1200 infants examined in the neonatal unit of Toulouse Regional Hospital from January 88 through December 89, we tried to summarize our findings and assess the value of systematic screening. We found 118 infants with abnormal examination: 58 preterms had retinopathy of prematurity (ROP) (5.16%) with 36 stage I, 15 stage II, 7 stage III (2 stage III+ had cryotherapy), no stage IV. Risk factors are discussed. 40 preretinal hemorrhages, all found in the first week of life. Only 2 of them persisted beyond the 2nd month (0.2%) and we found vascular anomalies that were cryotreated. 20 had various diseases. Diseases requiring early treatment were found in a general context with obvious need of ophthalmologic examination. Our study shows that 4 infants: 2 ROP III+ and 2 retinal hemorrhages or 0.4% of all infants obtained an effective benefit from this systematic screening. We confirmed the value of this screening: all infants in the neonatal care unit have at least one ophthalmologic exam, before they leave the hospital. Preterm less than 1600 g or less than 2000 g with initial resuscitation are checked during first and second month. Preterm less than 1200 g or less than 1600 g who had more than one month of oxygen therapy are checked every month until the 6th month.