Wide-field digital imaging system is more efficacious than r
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A Study was conducted to compare neonatal eye screening using the red reflex test (RRT) versus the wide-field digital imaging (WFDI) system which infers that WFDI has a better sensitivity than the existing gold standard, enables for the early detection and treatment of potentially blinding ocular disease that RRT misses.

A paediatrician performed RRT and the authors performed WFDI on newborns (n = 380, 760 eyes). The authors looked at wide-field digital imaging (WFDI) images. The unweighted kappa [K] statistic, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were used to test the validity of the paediatrician's RRT (NPV).

Results:
--While WFDI showed abnormalities in 130 eyes, RRT was only abnormal in 13 eyes.

--Wide-field digital imaging (WFDI) detected treatable retina pathology that RRT missed including hyphema, CMV retinitis, FEVR and a vitreous haemorrhage.

--The sensitivity of the paediatrician’s RRT to detect abnormalities was poor at 0.77% with a PPV of only 7.69%.

--Overall, there was no agreement between screening modalities (K = -0.02).

--The number needed to screen to detect ocular abnormalities using WFDI was 5.9 newborns and to detect treatable abnormalities was 76 newborns.

Finally, while RRT detects major abnormalities that prevent viewing of the retina (media opacities and big tumors, for example), only WFDI consistently detects modest curable retina and optic nerve diseases. Universal WFDI, which has a better sensitivity than the existing gold standard, enables for the early detection and treatment of potentially blinding ocular disease that RRT misses.

Source: https://onlinelibrary.wiley.com/doi/10.1111/aos.14759?af=R
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