Ospina L H, Lyons C J, Matsuba C, Jan J, McCormick A Q
Department of Ophthalmology, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Eye (Lond). 2005 Nov;19(11):1213-8. doi: 10.1038/sj.eye.6701729.
To assess the visual, refractive, ocular structural, and neurodevelopmental outcome in a group of children who were screened, treated with laser photocoagulation for threshold retinopathy of prematurity (ROP), and followed up at our institution.
The 21 survivors of a cohort of 23 children were recalled at the age of 5 years or more. They underwent a full ophthalmologic examination. A paediatric neurologist and/or developmental paediatrician performed a neurodevelopmental assessment and a neuropsychologist performed psychological testing.
A total of 30 eyes (71.4%) had a best-corrected visual acuity (BCVA) of 20/40 or better. In all, 26 (62%) eyes were myopic; the overall mean spherical equivalent was -4.95 D. No eye had Stage 4 findings and only one eye (2.4%) progressed to stage 5 despite photocoagulation. In total, 14 patients (66.6%) showed evidence of stereopsis. Strabismus was seen in six patients (28.5%) and nystagmus in three (14.3%). Periventricular leukomalacia (PVL) was identified in five patients (23.8%), cerebral palsy (CP) in seven (33.3%), and intraventricular haemorrhage (IVH) in 13 (62%). Cerebral palsy and IVH associated strongly with visual acuity of less than 20/40 (P=0.009 and 0.047). There was also a strong association between visual acuity of 20/40 or above and a better cognitive outcome (P=0.013).
Retinal scarring and detachment are relatively rare causes of visual morbidity 5 years or more after laser treatment for threshold ROP, but the neurological sequelae of extreme prematurity and amblyopia remain important causes of impaired visual function.
评估一组接受筛查、因阈值早产儿视网膜病变（ROP）接受激光光凝治疗并在我院随访的儿童的视力、屈光、眼部结构和神经发育结局。
23名儿童队列中的21名幸存者在5岁及以上时被召回。他们接受了全面的眼科检查。一名儿科神经科医生和/或发育儿科医生进行了神经发育评估，一名神经心理学家进行了心理测试。
总共30只眼（71.4%）的最佳矫正视力（BCVA）为20/40或更好。总共有26只眼（62%）近视；总体平均球镜当量为-4.95D。没有眼睛出现4期病变，尽管进行了光凝治疗，但只有一只眼（2.4%）进展到5期。总共14名患者（66.6%）有立体视证据。6名患者（28.5%）出现斜视，3名患者（14.3%）出现眼球震颤。5名患者（23.8%）被诊断为脑室周围白质软化（PVL），7名患者（33.3%）被诊断为脑瘫（CP），13名患者（62%）被诊断为脑室内出血（IVH）。脑瘫和IVH与视力低于20/40密切相关（P=0.009和0.047）。视力为20/40或以上与更好的认知结局之间也存在密切关联（P=0.013）。
对于阈值ROP，激光治疗5年及以上后，视网膜瘢痕形成和脱离是相对罕见的视力损害原因，但极早产和弱视的神经后遗症仍然是视力功能受损的重要原因。
