Red reflex examination in neonates: evaluation of 3 years of screening.
OBJECTIVE
Red reflex is a test that can detect potentially life-threatening ocular abnormalities. In 2012, a red reflex screening campaign was started in Umbria, central Italy. In this study, we report the results of the first 3 years (2012-2014) of screening.


METHODS
Red reflex screening was carried out in the 11 regional birth centres. On the first level, the test was performed on all newborns within the third day of life. A pathologic test was an indication for referral to the nearest Ophthalmology Hospital Department (II level). Patients were referred to the Perugia University Ophthalmology Hospital Department if an ulterior evaluation or if treatment was necessary (III level).


RESULTS
Between 1 January 2012 and 31 December 2014, 22,884 children were born in Umbria and of these, 22,272 (97.3%) were tested with the red reflex. Four hundred and sixty-one (4.83%) neonates resulted having a positive or equivocal test and were sent to II level. Three of these cases (0.01%) were affected by an important eye disease, in particular two patients (0.009%) presented congenital cataract and one patient (0.005%) presented retinoblastoma.


CONCLUSIONS
Our results are consistent with the previous findings, although reports on red reflex screening are sporadic in the literature. Despite the high number of false positives, the red reflex test has proven to be a useful, easy to perform and low cost test for the early detection of congenital low vision diseases, and our data confirm that it must become part of normal neonatal assessments.
Division of Ophthalmology, Department of Surgical and Biomedical Sciences, Ospedale S. Maria della Misericordia, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy. carlo.cagini@unipg.it.
Carlo
http://orcid.org/0000-0002-3812-9219
C
Cagini
Division of Ophthalmology, Department of Surgical and Biomedical Sciences, Ospedale S. Maria della Misericordia, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy.
Gianluigi
G
Tosi
Public Health Section, Department of Experimental Medicine, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy.
Fabrizio
F
Stracci
Division of Ophthalmology, Department of Surgical and Biomedical Sciences, Ospedale S. Maria della Misericordia, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy.
Victoria Elisa
VE
Rinaldi
Division of Ophthalmology, Department of Surgical and Biomedical Sciences, Ospedale S. Maria della Misericordia, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy.
Alberto
A
Verrotti
D005124:Eye Abnormalities / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D009887:Ophthalmoscopy / Q000379:methods*; D012025:Reflex, Pupillary / Q000502:physiology*; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D013997:Time Factors; D015351:Vision Screening / Q000379:methods*
Congenital alterations; Red reflex; Retinopathy of the premature; Screening