Interview with Dr. Sabrina Schlüter at the University Hospital in Essen – Significantly better prognosis for the eye and survival
On the initiative of the KinderAugenKrebsStiftung, the Brückner test was included in the catalog of U2 to U7 examinations as a mandatory examination on September 1, 2016.
After exactly five years, the experts at Essen University Hospital draw a conclusion.
It is a good conclusion – because the mandatory Brückner test has led to a tenfold increase in diagnoses.
From Sabrina Schlüter
The transillumination test according to Brückner, also known as the transillumination or red reflex test, is a painless exposure of both eyes simultaneously with an ophthalmoscope (light source) in a darkened room.
It can also be carried out easily on infants, small children and people with disabilities.
Dilating eye drops are not necessary for this examination, but can increase the accuracy of the examination.
Prior to 01.09.2016, there was only a recommendation from the professional association of ophthalmologists/pediatricians/adolescent doctors that an ophthalmological examination should be carried out from the 30th month of life, or from the 6th month if there are corresponding risk factors such as strabismus in parents/siblings, inherited eye diseases, premature babies, multiple disabilities or syndromic diseases.
Since September 1, 2016, the Brückner test has been a mandatory or fixed part of the paediatric examination from U2, i.e. between the 3rd and 10th day of life, and should be carried out in a darkened room.
The aim of this test is to show the “red glow” of the retina, in particular the central reflex (fovea).
Due to the good blood supply to the choroid, a red glow appears in the pupillary plane; in children this can also appear slightly grayish.
It is important to ensure that the reflex is equal on both sides.
The causes of a different retinal reflex can be varied.
Some merely require monitoring (malformations and scars on the retina), others require treatment (myopia/ hyperopia, astigmatism, benign vascular changes in the retina, congenital cataracts, etc.).
In the case of retinoblastoma, the disease is life-threatening and must be treated urgently.
The earlier the better, which is why the Brückner test is so important, especially in the presence of a retinoblastoma!
This is because an earlier diagnosis may enable eye-preserving therapy.
According to a data analysis by experts at Essen University Hospital, the introduction of the mandatory Brückner test has now made it possible to diagnose retinoblastoma earlier in many cases.
It was not always possible to preserve the affected eye, but in the majority of cases the diagnosis by the pediatrician as part of the U examination ensured an earlier start to treatment and therefore a significantly better prognosis for the affected eye and the survival of the child.
Nevertheless, cooperation between pediatricians and ophthalmologists must be further intensified and rapid referral to the appropriate centers must be ensured so that even more children can be found even earlier.
The graph illustrates the increase in the referral of retinoblastoma patients due to a pathological bridge test following its mandatory introduction into the catalog of U examinations.