Impact of retinopathy of prematurity screening examination on cardiorespiratory indices: a comparison of indirect ophthalmoscopy and retcam imaging

Abstract

Purpose: To compare the impact of retinopathy of prematurity (ROP) screening examination between a digital fundus camera and conventional binocular indirect ophthalmoscopy (BIO) using cardiorespiratory indices as a measure of distress.

Design: Prospective comparative (nonrandomized) interventional study.

Participants: Eighty-six preterm infants with a birth weight of < or =1500 g or gestational age of < or =32 weeks and undergoing ROP screening were included.

Methods: Retinopathy of prematurity screening examination with BIO or the digital fundus camera was performed. Cardiovascular indices were recorded before, during, and 1 hour after examination. Race, birth weight, gender, twin status, duration of the examination, gestational age, and postconceptual age were recorded.

Main outcome measures: Heart rate (HR), oxygen saturation, respiratory rate (RR), and mean blood pressure (BP).

Results: Thirty-four infants underwent indirect ophthalmoscopy, whereas 52 underwent digital fundus camera examination. The increase in HR and RR was significantly higher in the indirect ophthalmoscopy group than in the digital fundus camera group (P<0.05). There was a significant increase in HR and mean BP during examination in both groups (P<0.05). No clinically significant response persisted at 1 hour. Digital fundus camera examination took significantly longer (P<0.001).

Conclusions: Screening for ROP with a digital fundus camera is associated with a significantly lower stress-related response than conventional indirect ophthalmoscopy.