Gnanaraj L, Brennan R, Cottrell D G
Department of Ophthamology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
Eye (Lond). 2003 Mar;17(2):189-93. doi: 10.1038/sj.eye.6700295.
To determine the long-term outcome of treatment for threshold retinopathy of prematurity (ROP) in one UK unit.
A total of 35 infants diagnosed with threshold ROP were treated by a single ophthalmologist (DGC) between 1987 and 1998. The parents of the 29 surviving patients were contacted; 21 brought their child for special review of acuity, motility, refraction and fundoscopy (Group 1). Of the eight patients who were unable to attend, six patients (Group 2) had sufficient follow-up detail in their records to be included in the study.
A total of 40 eyes in the 21 patients in Group 1 had been treated; 10 had received cryotherapy (eight bilateral) and 11 had bilateral laser. Mean follow-up was 5 years (range 2-12 years). A total of 23 treated eyes (in 16 patients) had an acuity of 6/12+ (57.5% of treated eyes). Four eyes of three patients had no light perception. Seven eyes in four patients had myopia of more than 3 D. Eight patients had a manifest squint: six esotropia, two exotropia. The retinal status of 36 eyes (90%) showed a favourable outcome. The four blind eyes had stage 5 disease. In Group 2, four eyes of two patients (33%) had 6/12+ acuity recorded; five eyes in three patients had stage 5 disease and no perception of light. In total, a favourable structural outcome was achieved in 81.4% and favourable functional outcome observed in 74.6%.
These results show that the favourable outcomes reported in the CRYO-ROP trial can be achieved in routine practice and maintained after long follow-up.
确定英国一家医疗单位对阈值早产儿视网膜病变(ROP)的长期治疗效果。
1987年至1998年间,一名眼科医生(DGC)共治疗了35例被诊断为阈值ROP的婴儿。联系了29名存活患者的父母;其中21名带孩子前来进行视力、眼球运动、验光和眼底检查的专项复查(第1组)。在8名无法前来的患者中,有6名患者(第2组)的病历中有足够的随访细节可纳入研究。
第1组的21例患者中共有40只眼接受了治疗;10只眼接受了冷冻疗法(8只为双眼),11只眼接受了双眼激光治疗。平均随访时间为5年(范围2 - 12年)。共有23只接受治疗的眼睛(16例患者)视力达到6/12或更好(占接受治疗眼睛的57.5%)。3例患者的4只眼睛无光感。4例患者的7只眼睛近视度数超过3D。8例患者有明显斜视:6例内斜视,2例外斜视。36只眼睛(90%)的视网膜状况显示预后良好。4只失明眼睛患有5期疾病。在第2组中,2例患者的4只眼睛(33%)记录的视力为6/12或更好;3例患者的5只眼睛患有5期疾病且无光感。总体而言,81.4%的患者获得了良好的结构预后,74.6%的患者观察到了良好的功能预后。
这些结果表明,在常规治疗中可以取得CRYO - ROP试验中报告的良好预后,并且经过长期随访仍可维持。