Trinavarat Adisak, Atchaneeyasakul La-ongsri, Udompunturak Suthipol
Department of Ophthalmology, Siriraj Hospital Mahidol University, Bangkok, Thailand.
Jpn J Ophthalmol. 2004 Jan-Feb;48(1):50-3. doi: 10.1007/s10384-003-0014-2.
The aim of this study was to verify the applicability of standard guidelines for the screening of retinopathy of prematurity (ROP) and to determine the appropriate criteria for Thai neonates.
Records of ROP screening of infants born in our hospital between 1995 and 2000 with a birth weight below 2000 g or a gestational age of less than 36 weeks were studied. Criteria to screen infants with a birth weight below 1500 g or a gestational age of less than 28 weeks in the American guidelines and similar birth weight but a gestational age of less than 31 weeks in the British recommended guidelines were applied and evaluated in terms of sensitivity and specificity. Criteria reaching 100% sensitivity with the maximum specificity were deemed appropriate.
Of the 514 screened infants, 33 had developed stage 2+ ROP and beyond. The mean +/- SD birth weight and gestational age were 1046 +/- 257 (710-1680 g) and 29.2 +/- 2.5 weeks (24-35 weeks), respectively. The age at intervention was 6-16 weeks. Sensitivity for both American and British guidelines was 93.9%. By screening infants with birth weights below 1500 g or gestational age less than 33 weeks, we could achieve 100% sensitivity with 18.3% specificity. We decided that the initial examination should be performed 4-6 weeks after birth. By applying these criteria to 62 referred cases we also were able to include in the screening all cases of concern in this group.
Regional criteria for ROP screening is required and should be evaluated periodically and modified accordingly.
本研究旨在验证早产儿视网膜病变（ROP）筛查标准指南的适用性，并确定适用于泰国新生儿的标准。
研究了我院1995年至2000年间出生、出生体重低于2000g或胎龄小于36周的婴儿的ROP筛查记录。应用美国指南中对出生体重低于1500g或胎龄小于28周婴儿的筛查标准，以及英国推荐指南中对出生体重相似但胎龄小于31周婴儿的筛查标准，并从敏感性和特异性方面进行评估。达到100%敏感性且特异性最高的标准被认为是合适的。
在514例接受筛查的婴儿中，33例发生了2+期及以上的ROP。出生体重和胎龄的均值±标准差分别为1046±257（710-1680g）和29.2±2.5周（24-35周）。干预时的年龄为6-16周。美国和英国指南的敏感性均为93.9%。通过筛查出生体重低于1500g或胎龄小于33周的婴儿，我们可以达到100%的敏感性，但特异性为18.3%。我们决定初始检查应在出生后4-6周进行。将这些标准应用于62例转诊病例时，我们也能够将该组中所有相关病例纳入筛查。
需要ROP筛查的地区性标准，并且应定期评估并相应修改。
