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Abnormal red reflex indicates ocular disease in infants: JAMA
Denmark: A normal red reflex does not exclude ocular disease but an abnormal red reflex most likely reflects an underlying ocular pathology while screening in infants, suggests a recent study in the journal JAMA Ophthalmology.
Red reflex testing is an essential component of the neonatal, infant, and child physical examination according to a joint policy statement by American Association of Certified Orthoptists, the American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and the American Academy of Pediatrics. It is simple and inexpensive method implemented in many countries as an essential part of infant screening for ocular pathologies.
Yousif Subhi, Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark, and colleagues reviewed the literature on the diagnostic accuracy of the red reflex test in infant screening for ocular pathologies and to perform meta-analyses to provide summary estimates.
The researchers searched the online databases for studies published until April 19, 2020. Eligibility criteria were defined according to population (studies of consecutively screened infants), exposure (red reflex or Brückner test as the index test), comparator (any ophthalmological examination), and study type (any study with diagnostic test accuracy data).
Main outcome measures included true-positive, false-positive, true-negative, and false-negative findings; sensitivity; specificity; and positive and negative predictive values. This meta-analysis included a total of 8713 unique infants from 5 unique studies.
Key findings of the study include:
- All the included studies used the red reflex test without pupillary dilation and were compared with a reference test performed with pupillary dilation.
- For any ocular pathology, an estimated sensitivity of 7.5% and specificity of 97.5% was found.
- Focusing on ocular pathologies that required a medical or surgical intervention, sensitivity improved to 17.5% and specificity remained high at 97.6%.
"Our findings demonstrate that an abnormal red reflex finding most likely reflects an underlying ocular pathology. However, a normal red reflex finding during screening does not exclude ocular disease," concluded the authors.
"Diagnostic Test Accuracy of the Red Reflex Test for Ocular Pathology in Infants: A Meta-analysis," is published in the journal JAMA Ophthalmology.
DOI: https://jamanetwork.com/journals/jamaophthalmology/fullarticle/10.1001/jamaophthalmol.2020.4854
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751