Title : Incidence of congenital cataracts and efficacy of the ocular screening programme for term neonates in Northern Ireland: A retrospective population study
Abstract:
Purpose:
This study aims to determine the incidence of congenital cataract in Northern Ireland (NI) and to evaluate the efficacy of the Red Reflex Test (RRT) as a screening tool.
Methods:
A retrospective review of abnormal red reflex referrals between January 2017 and 2019 was undertaken. Data relating to the source and timing of referrals as well as the diagnostic outcome was collated. Additional data was collected on the incidence of visually significant cataract within this cohort, and the frequency of surgical intervention. Analysis was subsequently undertaken to calculate the sensitivity and specificity of the RRT.
Results:
In the study period, 193 children were referred with an abnormal RRT, of which 27% were detected through the 0 to 72-hour Neonatal Infant Physical Examination (NIPE) neonatal screening, and 14% were identified during the 6–8-week NIPE screening. Twenty-two (11.4%) patients were found to have true red reflex abnormality. Nine infants were diagnosed with lens opacities which required surgical intervention. The incidence of congenital cataract in NI is estimated at 3.7 per ten thousand live births per year. The sensitivity of the RRT was calculated at 40.9% with a specificity of 99.67%.
Conclusions:
The findings of this study indicate that NI has a higher incidence of congenital cataract compared to the other nations within the United Kingdom (UK). It also highlights issues with the efficacy of the RRT as an isolated screening tool as despite having high specificity, it is associated with a high number of false positives and therefore limited sensitivity.
