Hardy R J, Palmer E A, Schaffer D B, Phelps D L, Davis B R, Cooper C J
University of Texas Health Science Center at Houston, School of Public Health 77030, USA.
J AAPOS. 1997 Mar;1(1):46-54. doi: 10.1016/s1091-8531(97)90023-9.
A system is presented for sequentially computing the risk of progression of retinopathy of prematurity (ROP) for infants born weighing not more than 1250 gm. A personal computer program is used to monitor infants' risk of threshold ROP from first appearance of ROP, and the progression in severity is tracked with multiple logistic risk models developed from data in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity.
After entry of the infant's birth weight, gestational age, ethnicity, birth in the current hospital or elsewhere, single or multiple birth, and maturity zone of retinal vessels, risk of progression to threshold severity is calculated. New estimates of risk are computed at onset of ROP and prethreshold ROP (any zone I ROP, zone II stage 2+ or 3) according to the extent of retinal vascularization when ROP first appears, how rapidly ROP progresses, and how severe it is. When threshold ROP (8 total or 5 contiguous clock hours of stage 3+ in zone I or II) is reached,the system provides separate estimates of risk that the eye will have an unfavorable 3-month outcome if treated or not.
Estimates of risk of progression to threshold disease among the 4099 patients in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity natural history study varied from less than 1% to more than 70%. For eyes with threshold disease, the risk of an unfavorable outcome at 3 months without treatment varied from less than 10% to more than 90%.
This method of tracking identifies infants at high risk for severe ROP and poor structural outcome. It provides information about prognosis with a specificity heretofore impossible.
提出一种用于顺序计算出生体重不超过1250克婴儿的早产儿视网膜病变（ROP）进展风险的系统。使用个人计算机程序从ROP首次出现开始监测婴儿发生阈值ROP的风险，并利用早产儿视网膜病变冷冻疗法多中心试验的数据开发的多个逻辑风险模型来跟踪病情严重程度的进展。
输入婴儿的出生体重、胎龄、种族、在当前医院或其他地方出生、单胎或多胎以及视网膜血管的成熟区后，计算进展至阈值严重程度的风险。根据ROP首次出现时视网膜血管化的程度、ROP进展的速度以及严重程度，在ROP发作和阈值前ROP（任何I区ROP、II区2+或3期）时计算新的风险估计值。当达到阈值ROP（I区或II区3+期共8个或连续5个钟点）时，该系统分别提供关于眼睛治疗或不治疗时3个月不良结局风险的估计值。
在早产儿视网膜病变冷冻疗法自然史研究的多中心试验中的4099例患者中，进展至阈值疾病的风险估计值从不到1%到超过70%不等。对于患有阈值疾病的眼睛，未经治疗3个月时不良结局的风险从不到10%到超过90%不等。
这种跟踪方法可识别出发生严重ROP和不良结构结局的高危婴儿。它以前所未有的特异性提供有关预后的信息。
