Hellström A, Hård A L, Svensson E, Niklasson A
Department of Clinical Neuroscience, Queen Silvia Children's Hospital, Göteborg, Sweden.
Eye (Lond). 2000 Jun;14 ( Pt 3A):324-9. doi: 10.1038/eye.2000.81.
Preterm birth has been found to be associated with increased morbidity of the central nervous and vascular tissues. To investigate the influence of preterm birth on the optic disc and retinal vessels, we examined the ocular fundus in school-aged children born very preterm.
A prospective, population-based study was performed in 50 very preterm children (median age 7 years, range 5-9 years) with a median gestational age at birth of 27 weeks (range 24-28 weeks) and a median birth weight of 1055 g (range 450-1520 g). The ocular fundus was examined by ophthalmoscopy in 50 children, and the optic nerve and retinal vessel morphology was evaluated by digital image analysis of ocular fundus photographs in 45 of these children.
The median optic disc area was significantly smaller (p = 0.0002) in the preterm children compared with a reference group. There was no difference in cup area and, consequently, the rim area was significantly smaller (p = 0.0002) in the preterm children. Children with early signs of brain lesions commonly had a rim area below the median of the reference group. Preterm children also commonly had an abnormal retinal vascular pattern that was independent of a previous history of retinopathy of prematurity.
Very preterm birth was associated with subnormal optic disc and rim areas and an abnormal vascular pattern. The findings clearly demonstrate the effect of preterm birth on the development of these structures. The long term clinical prognosis of these findings has yet to be determined.
已发现早产与中枢神经和血管组织发病率增加有关。为了研究早产对视盘和视网膜血管的影响，我们检查了极早早产出生的学龄儿童的眼底。
对50名极早早产儿童（中位年龄7岁，范围5 - 9岁）进行了一项基于人群的前瞻性研究，这些儿童出生时的中位孕周为27周（范围24 - 28周），中位出生体重为1055克（范围450 - 1520克）。对50名儿童进行了眼底镜检查，其中45名儿童通过眼底照片的数字图像分析对视神经和视网膜血管形态进行了评估。
与参照组相比，早产儿的视盘面积中位数显著更小（p = 0.0002）。杯状区域没有差异，因此，早产儿的视盘边缘面积显著更小（p = 0.0002）。有早期脑损伤迹象的儿童通常视盘边缘面积低于参照组中位数。早产儿还普遍存在异常的视网膜血管模式，且与既往早产儿视网膜病变病史无关。
极早早产与视盘和视盘边缘面积低于正常以及血管模式异常有关。这些发现清楚地证明了早产对这些结构发育的影响。这些发现的长期临床预后尚待确定。
