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Physiological responses to retinopathy of prematurity screening: indirect ophthalmoscopy versus ultra-widefield retinal imaging

Abstract:
Background/Aims
Retinopathy of prematurity (ROP) screening is vital for early disease detection in very premature infants but can cause physiological instability. This study compares the physiological response to binocular indirect ophthalmoscopy (BIO) with indentation and non-contact ultra-widefield (UWF) retinal imaging in non-ventilated neonates. The impact of the Dandle WRAP, a specialised swaddling aid, on UWF imaging was also assessed.

Methods
This retrospective study included 86 ROP screening events in 66 non-ventilated infants aged 35.3 weeks (range 30.6–44.6). Vital signs were continuously recorded, evaluating immediate (within 15 min) and longer-term (within 12 h) physiological responses.

Results
ROP screening significantly increased heart and respiratory rates and decreased oxygen saturation within 15 min of screening. No significant differences in physiological responses were found between BIO and UWF imaging, although there was a trend towards lower maximum heart rate with UWF imaging. The Dandle WRAP did not significantly alter physiological responses but improved the ease and speed of UWF imaging.

Conclusion
UWF imaging does not increase physiological instability compared to BIO in non-ventilated infants. Specialised swaddling aids may facilitate the imaging procedure.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1038/s41390-025-03906-4

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Paediatrics
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Paediatrics
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Paediatrics
Role:
Author


More from this funder
Funder identifier:
https://ror.org/029chgv08
Funding agency for:
Xue, K
Hartley, C
Grant:
216593/Z/19/Z
213486/Z/18/Z
More from this funder
Funder identifier:
https://ror.org/051x4wh35
Funding agency for:
Usman, F
More from this funder
Funder identifier:
https://ror.org/00aps1a34
Funding agency for:
Xue, K


Publisher:
Springer Nature
Journal:
Pediatric Research More from this journal
Volume:
98
Issue:
5
Pages:
1801–1808
Place of publication:
United States
Publication date:
2025-02-13
Acceptance date:
2024-12-30
DOI:
EISSN:
1530-0447
ISSN:
0031-3998
Pmid:
39948384


Language:
English
Pubs id:
2085961
Local pid:
pubs:2085961
Deposit date:
2025-02-19
ARK identifier:

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