Graziano R M, Leone C R, Cunha S L, Pinheiro A C
Departamento de Oftalmologia e Otorrinolaringologia, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP.
J Pediatr (Rio J). 1997 Nov-Dec;73(6):377-82. doi: 10.2223/jped.564.
Evaluate the prevalence of retinopathy of prematurity (ROP) in very low birthweight infants (birthweight<1500 g).
A prospective examination was conducted on 102 neonates with very low birthweight admitted to the BAM-HC (FMUSP) between 01/01/92 and 12/31/93. The mapping of the retina with scleral depression was first conducted between 3rd and the 8th weeks of life, and it was repeated every 1 to 4 weeks until the vascularization of the retina was complete or the ROP was present. To classify the ROP the International Classification of ROP was used. For the purposes of statistical analysis, the most serious phase of ROP presented by the neonate was considered.
In this study retinopathy of prematurity was present in 29.09% of the neonates, in 78.5% of those under 1,000 g of birthweight, and 72.73% of those with less than 30 weeks of gestational age. Among the newborns with ROP, 77.05% were in phase 1, 13.11% in phase 2, and 9.84% in phase 3. Oxygen in mechanical ventilation and "CPAP" were statistically significant factors for the development the ROP.
The ophthalmologic examination between the 3rd and 4th weeks of life was an important instrument for the detection of RP and should be done in all very low birth weight infants (weight<1,500 g), especially in neonates with less than 1,250 g and/or gestational age under 34 weeks.
评估极低出生体重儿(出生体重<1500g)中早产儿视网膜病变(ROP)的患病率。
对1992年1月1日至1993年12月31日期间入住BAM-HC(FMUSP)的102例极低出生体重儿进行前瞻性检查。在出生后第3至8周首次进行巩膜压迫下的视网膜检查,并每1至4周重复一次,直至视网膜血管化完成或出现ROP。采用国际ROP分类法对ROP进行分类。为进行统计分析,考虑新生儿出现的ROP最严重阶段。
本研究中,29.09%的新生儿患有早产儿视网膜病变,出生体重低于1000g的新生儿中78.5%患病,胎龄小于30周的新生儿中72.73%患病。在患有ROP的新生儿中,77.05%处于1期,13.11%处于2期,9.84%处于3期。机械通气和“持续气道正压通气(CPAP)”中的吸氧是ROP发生的统计学显著因素。
出生后第3至4周的眼科检查是检测ROP的重要手段,所有极低出生体重儿(体重<1500g)均应进行此项检查,尤其是出生体重低于1250g和/或胎龄小于34周的新生儿。