Eventov-Friedman Smadar, Leiba Hana, Flidel-Rimon Orna, Juster-Reicher Ada, Shinwell Eric S
Department of Neonatology, Kaplan Medical Center, Rehovot, Israel.
Isr Med Assoc J. 2010 May;12(5):259-61.
The American Academy of Pediatrics recently published recommendations for the red reflex assessment in the newborn period to detect and treat ocular disorders as early as possible, and to prevent lifelong visual impairment and even save lives. The test is technically simple to perform, non-invasive, requires minimal equipment and can detect a variety of ocular pathologies including cataracts and retinal abnormalities. No specific national guidelines exist on this issue.
To document the implementation of red reflex examination in routine neonatal care and present the findings.
Our clinical experience following inclusion of the red reflex test into the newborn physical examination in a single center was reviewed. In addition, an electronic mail questionnaire was sent to all neonatology departments in Israel regarding performance of the red reflex test.
During 2007-2008, five infants were identified with congenital cataracts at days 2-6 of life prior to discharge from hospital. Surgery was performed in one infant at age 2 months and all infants underwent a thorough follow-up. The incidence of congenital cataract in our center was 1:2300. Less than half the neonatology departments have endorsed the AAP recommendation and perform the red reflex test routinely.
Abnormal red reflex test after delivery enables a rapid ophthalmologic diagnosis, intervention and close followup. We recommend that red reflex screening be performed as part of the newborn physical examination; if abnormal, an urgent ophthalmologic referral should be made.
美国儿科学会最近发布了关于新生儿期红光反射评估的建议，以便尽早检测和治疗眼部疾病，预防终身视力损害甚至挽救生命。该测试在技术上操作简单、无创，所需设备最少，并且能够检测包括白内障和视网膜异常在内的多种眼部病变。在这个问题上尚无具体的国家指南。
记录红光反射检查在常规新生儿护理中的实施情况并展示结果。
回顾了我们在一个中心将红光反射测试纳入新生儿体格检查后的临床经验。此外，还向以色列所有新生儿科发送了一封电子邮件问卷，询问红光反射测试的执行情况。
在2007 - 2008年期间，有5名婴儿在出院前的出生后第2至6天被确诊患有先天性白内障。1名婴儿在2个月大时接受了手术，所有婴儿都接受了全面的随访。我们中心先天性白内障的发病率为1:2300。不到一半的新生儿科认可美国儿科学会的建议并常规进行红光反射测试。
出生后红光反射测试异常可实现快速眼科诊断、干预及密切随访。我们建议将红光反射筛查作为新生儿体格检查的一部分进行；如果结果异常，应紧急转诊至眼科。
