Prematüre Retinopatisi Tarama Muayenesini Zorlaştıran Bir Durum: Bell Fenomeni

Abstract

Objective: To evaluate the expression of Bell's phenomenon (BP) in premature infants and to discuss the effects of BP expression on retinopathy of prematurity screening examination. Material and Methods: Consecutive infants admitted for retinopathy of prematurity screening examination were all recruited. The expression of BP was evaluated just after the insertion of the blepharostat and during illumination of the eye by the binocular indirect ophthalmoscopic light beam. BP was recorded as grade 0 when there is no expression, grade 1 when partial response is present (the center of pupil visible) and grade 2 when full response is present (the center of pupil is not visible). Results: A total of 152 infants with a mean gestational age of 31.4±2.8 weeks and a mean birth weight of 1705.0±543.3 g. were enrolled in the study. Fourty-two (30.3%) grade 0, 70 (46.0%) grade 1 and 36 (23.7%) grade 2 responses were observed just after the insertion of the blepharostat. After illumination of the eye with the indirect ophthalmoscope, 31 (20.4%) grade 0, 60 (39.5%) grade 1 and 61 (40.1%) grade 2 responses were observed. No significant association was found between the gestational age and the frequency of BP just after insertion of the blepharostat. (p=0.856) However, there was a statistically significant difference of the expression frequency of BP between different age groups during illumination with the light of binocular indirect ophthalmoscope (p=0.008). Conclusion: BP is commonly encountered in premature infants during retinopathy of prematurity screening examination. It should be taken into consideration during screening examination and laser treatment under topical anesthesia in order to prevent conjunctival injury and anterior segment ischemia.