Blackledge Jon, Lang Dustin M, Arnold Robert W
Pediatric Ophthalmology and Strabismus Ophthalmic Associates, 542 West Second Avenue, Anchorage, Alaska 99501-2242, USA.
Alaska Med. 2005 Jul-Sep;47(2):2-5.
Most infants cry with lid speculum, scleral depression and indirect ophthalmoscopy. This simple observation, "did the infant cry?" during the initial 31-week ROP screening exam was prospectively studied.
From Fall 1989 through Summer 2003, all Alaskan infants with birthweight < or = 1500 grams were examined by RWA. After 1992, at the 31-week initial ROP screening, we recorded whether the infant was able to cry (cry), did not cry (quiet), or was intubated (vent) during indirect ophthalmoscopy with lid speculum and scleral depression.
ROP was classified as to threshold in 873 infants. Infants who were able to cry during their 31-week GA screening exam were less likely to progress to threshold (Chi square 600, 2 = 36, p < .001). Using a logistic fit of Threshold, the increased risk of ROP in infants unable to cry persisted independent of gestational age or birthweight.
Respiratory and neurologic co-morbidity may render those infants unable to cry during the first screening examination at increased risk to progress to threshold ROP.
大多数婴儿在使用眼睑撑开器、巩膜压迫法和间接检眼镜检查时会哭闹。我们对在31周龄的首次视网膜病变（ROP）筛查检查期间“婴儿是否哭闹”这一简单观察进行了前瞻性研究。
从1989年秋季到2003年夏季，所有出生体重≤1500克的阿拉斯加婴儿均接受了视网膜病变加龄（RWA）检查。1992年之后，在31周龄的首次ROP筛查时，我们记录了婴儿在使用眼睑撑开器和巩膜压迫法进行间接检眼镜检查期间是否能够哭闹（哭闹）、未哭闹（安静）或已插管（通气）。
873名婴儿的ROP被分类为阈值病变。在31周龄的孕龄筛查检查期间能够哭闹的婴儿发展为阈值病变的可能性较小（卡方检验600,2 = 36，p <.001）。使用阈值病变的逻辑拟合，无法哭闹的婴儿发生ROP的风险增加，且与孕龄或出生体重无关。
呼吸和神经合并症可能使那些在首次筛查检查期间无法哭闹的婴儿发展为阈值ROP的风险增加。
