June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Adverse Events and Change in Vital Signs During 1,360 Retinopathy of Prematurity Screenings
Author Affiliations & Notes
  • Richard E Jones
    Ophthalmology, UT Health - San Antonio, San Antonio, Texas, United States
  • Sejal R Lahoti
    Long School of Medicine, San Antonio, Texas, United States
  • Kinley D Beck
    Ophthalmology, UT Health - San Antonio, San Antonio, Texas, United States
  • Sneha Paddidam
    Kresge Eye Institute, Detroit, Michigan, United States
  • Daniel Apple
    Kresge Eye Institute, Detroit, Michigan, United States
  • Xihui Lin
    Kresge Eye Institute, Detroit, Michigan, United States
  • Polly Ann Quiram
    University of Minnesota, Minneapolis, Minnesota, United States
  • Ryan Young
    Austin Retina Associates, Austin, Texas, United States
  • Jennifer Desireddi
    Pediatrics, St. David's Medical Center, Austin, Texas, United States
  • Clio Armitage Harper, III
    Austin Retina Associates, Austin, Texas, United States
  • Footnotes
    Commercial Relationships   Richard Jones, None; Sejal Lahoti, None; Kinley Beck, None; Sneha Paddidam, None; Daniel Apple, None; Xihui Lin, None; Polly Quiram, None; Ryan Young, None; Jennifer Desireddi, None; Clio Harper, III, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 2159. doi:
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      Richard E Jones, Sejal R Lahoti, Kinley D Beck, Sneha Paddidam, Daniel Apple, Xihui Lin, Polly Ann Quiram, Ryan Young, Jennifer Desireddi, Clio Armitage Harper, III; Adverse Events and Change in Vital Signs During 1,360 Retinopathy of Prematurity Screenings . Invest. Ophthalmol. Vis. Sci. 2020;61(7):2159.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To assess changes in vital signs, record total examination times, and document adverse events during retinopathy of prematurity (ROP) screenings.

Methods : We analyzed 1,360 screening exams from 711 infants completed in two neonatal intensive care units in Austin, Texas, from February 2015 to June 2017. Demographic information including birth weight, gestational age, and current age were recorded. Vital signs of the infants were documented prior to dilation, immediately before the examination, and again after the examination and included systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation. A combination drop of cyclopentolate hydrochloride 0.2% and phenylephrine 1% was administered twice five minutes apart. Approximately 30 minutes later, one of two retina specialists examined the infants using one drop of proparacaine, a sterile Alfonso lid speculum, an individual single use 28D lenses, and a sterile nasopharyngeal calgiswab for scleral depression. Examination times and adverse events were recorded. This was an institutional review board certified study.

Results : From the 1,360 infant screening exams, 153 (11%) resulted in at least one systemic change in vital signs, with one serious adverse event which required resuscitation. There were statistically significant changes in diastolic blood pressure, heart rate, and respiratory rate as a result of dilating drops. The examination itself had a statistically significant change in the following: systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation. The average length of examination was 63.7 seconds. No infections occurred as a result of our ROP screening examinations.

Conclusions : Screening examinations are vital for infants with increased risk for ROP. However, these screening examinations can result in systemic complications secondary to both the mydriatic drops and the examination itself. Limiting the concentration and amount of dilating drops, reducing examination times, and using sterile equipment can reduce but not eliminate adverse events.

This is a 2020 ARVO Annual Meeting abstract.

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