- Design
- Population-based retrospective cohort from a newborn screening programme
- Population
- 347 infants with congenital CMV detected on newborn screening in Ontario who had eye examinations
- Primary outcome
- Prevalence of CMV-related ophthalmic findings
- Effect
- 2 of 347 (0.58%), both symptomatic (3.9% of symptomatic); 0 of 296 asymptomatic
Ontario screens newborn dried blood spots for congenital cytomegalovirus. This study reviewed eye examination records for 347 of the 394 infants who screened positive between 2019 and 2022; 51 had symptomatic infection.
Only two infants had CMV-related eye findings, unilateral chorioretinal scars: 0.58% of those examined and 3.9% of the symptomatic group. Both had obvious systemic disease and had been referred before their screening result came back. None of the 296 asymptomatic infants had CMV-related eye findings.
Consensus guidance has recommended an eye examination for every infant with congenital CMV. This study suggests that, where infection is found by screening in a well baby, the yield is very low, and referral could be based on symptoms. India has no routine newborn CMV screening programme, so the practical relevance here is to infants diagnosed because they are unwell, who should still be examined.
- Arrange an eye examination for every infant with symptomatic congenital CMV.
- In asymptomatic infants found by screening, the yield of a routine eye examination was nil in this cohort.
- Hearing follow-up remains essential in all infants with congenital CMV, symptomatic or not.
- Follow local guidance until it changes; this is one cohort.
Why it matters
It questions a blanket referral that costs families and services time for very low yield.
Don't overread it
One provincial cohort with few events; current consensus guidance still recommends universal eye review.
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