Brennan R, Gnanaraj L, Cottrell D G
Department of Ophthamology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Eye (Lond). 2003 Mar;17(2):183-8. doi: 10.1038/sj.eye.6700296.
To review an 11-year period of screening for retinopathy of prematurity (ROP) in the north of England by a single ophthalmologist. To identify the gestational ages and birth weights of babies reaching different stages of ROP. To investigate the workload involved in screening to detect threshold ROP, and that the practical outcomes had narrower inclusion criteria for screening. To identify babies treated for threshold disease.
During the period August 1987-October 1998, babies were screened according to the national guidelines and the results were prospectively entered onto a computerised database. These data were then systematically reviewed.
Data were available for 484 babies: 203 (41.9%) developed any ROP, 46 (9.5%) reached stage 3 ROP, and 25 (5.2%) reached threshold and were treated. Data on 425 babies showed them to require an average of 2.3 screening examinations per baby. It took an average of 39 screening examinations to detect one case of threshold ROP. The more premature and lighter birth weight babies required the most examinations. Therefore, restricting the inclusion criteria for screening would only have reduced the total number of screenings modestly and could have allowed us to miss two of our threshold cases who were both of 30 weeks gestational age and >1400 g birth weight.
Screening is time consuming but worthwhile in view of the benefits of treatment. As applied to babies in the north of England, the current national screening criteria are satisfactory. The results of treatment of the babies identified in this study are presented in the accompanying paper.
回顾一位眼科医生在英格兰北部开展的为期11年的早产儿视网膜病变（ROP）筛查工作。确定达到不同ROP阶段婴儿的胎龄和出生体重。调查筛查出阈值ROP所涉及的工作量，以及实际筛查的纳入标准更为严格。确定接受阈值疾病治疗的婴儿。
在1987年8月至1998年10月期间，按照国家指南对婴儿进行筛查，并将结果前瞻性地录入计算机数据库。然后对这些数据进行系统回顾。
有484名婴儿的数据可供分析：203名（41.9%）出现了任何ROP，46名（9.5%）达到ROP 3期，25名（5.2%）达到阈值并接受了治疗。425名婴儿的数据显示，每名婴儿平均需要2.3次筛查检查。平均需要39次筛查检查才能发现1例阈值ROP。胎龄越小、出生体重越轻的婴儿需要的检查次数越多。因此，限制筛查的纳入标准只会适度减少筛查总数，而且可能会使我们错过2例阈值病例，这2例病例的胎龄均为30周，出生体重均>1400克。
鉴于治疗的益处，筛查虽然耗时但很有价值。就英格兰北部的婴儿而言，目前的国家筛查标准是令人满意的。本研究中确定的婴儿的治疗结果在随附的论文中呈现。
