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[1999年至2005年在波美拉尼亚医科大学眼科教研室及诊所接受治疗的早产儿组屈光不正和眼球位置异常的表现]

[The appearance of refractive errors and eyeballs position disorders in the group of premature babies treated at the Chair and Clinic of Ophthalmology of the Pomeranian Medical University in the years 1999-2005].

作者信息

Modrzejewska Monika, Kot Joanna, Grzesiak Wilhelm, Karczewicz Danuta

机构信息

Katedra i Klinika Okulistyki Pomorskiej Akademii Medycznej w Szczecinie al. Powstańców Wlkp. 72, 70-111 Szczecin.

出版信息

Ann Acad Med Stetin. 2007;53(1):57-62.

Abstract

INTRODUCTION

Retinopathy of prematurity (ROP) is a disease of the retina and the vitreous body present in children prematurely born. In the groups of babies with retinopathy of prematurity as well as among in the group of babies without pathological lesions, however, with retinal immaturity, occurrence of complications in the form of refractive errors and abnormality in the eyeballs position can be observed. The aim of the study was to analyze the frequency of occurrence of hypermetropia, myopia, astigmatism and eyeballs position disorders in the form of strabismus and nystagmus in premature babies.

MATERIAL AND METHODS

The study material consisted of 1052 newborns treated in the Outpatient Clinic of Ophthalmology for Premature Infants in Szczecin, between 1999-2005. Refractive errors were estimated, after cycloplegic retinoscopy (0.5% Tropicamidum and 2.5% Phenylephryni hydrochloridum). Refractive errors were recognized when hypermetropia was > or = +3.0 D, myopia > or = -0.5 D, astigmatism > or = 1.0 Dcyl. Among 65 babies of the analyzed group laser treatment of the retina was applied, the rest of the 987 infants were observed or have underwent a conservative treatment. The studied group of premature babies has been divided into the following subgroups: Group I--conservatively treated babies (n = 987), group II--diode laser treated babies (n = 65). The statistic analysis of refractive errors was done on the basis of Statistica v.7.1 [StatSoft, Inc. (2005). Statistica (data analysis system), version 7.1.]. The incidence of refractive errors was described with the help of chi-square test.

RESULTS

Refractive errors were recognized among 695 babies (70.49%) from group I and in 49 babies (75.39%) from group II. In the group of 987 infants whom were not treated with laser but conservatively a more frequent occurrence ofhypermetropia and astigmatism was observed--655 babies (66.33%) and 202 (20.46%) respectively. Myopia was most common in the laser treated group of babies: 19 patients (29.23%). In this group astigmatism was present in 9 babies (13.84%). Eyeballs position disorders in the form of strabismus and nystagmus were more common in the group of babies treated with laser (29.23% and 9.23%) comparing with conservatively treated babies (10.63% and 1.63%) respectively.

CONCLUSIONS

Hypermetropia and astigmatism could be more often observed in the group of premature babies in whom pathological ocular fundus lesions or a low stage of advancement of retinopathy of prematurity susceptible to self-regression were not recognized. Myopia was more often identified in the group of babies with an active stage of retinopathy of prematurity as well as in those in whom laser treatment was required. Eyeballs position disorders in the form of strabismus and nystagmus were more frequent in the group of babies with an active stage of retinopathy of prematurity in whom diode laser treatment was applied.

摘要

引言

早产儿视网膜病变(ROP)是一种发生于早产儿童的视网膜和玻璃体疾病。然而,在患有早产儿视网膜病变的婴儿群体以及没有病理性病变但视网膜不成熟的婴儿群体中,都可观察到以屈光不正和眼球位置异常形式出现的并发症。本研究的目的是分析早产儿中远视、近视、散光以及斜视和眼球震颤形式的眼球位置紊乱的发生频率。

材料与方法

研究材料包括1999年至2005年间在什切青早产儿眼科门诊接受治疗的1052名新生儿。在使用睫状肌麻痹剂散瞳验光(0.5%托吡卡胺和2.5%盐酸去氧肾上腺素)后评估屈光不正情况。当远视≥ +3.0 D、近视≥ -0.5 D、散光≥ 1.0 Dcyl时判定为屈光不正。在分析组的65名婴儿中进行了视网膜激光治疗,其余987名婴儿进行了观察或接受了保守治疗。所研究的早产儿组被分为以下亚组:第一组——保守治疗的婴儿(n = 987),第二组——二极管激光治疗的婴儿(n = 65)。基于Statistica v.7.1软件[StatSoft公司(2005年)。Statistica(数据分析系统),版本7.1。]对屈光不正进行统计分析。屈光不正的发生率通过卡方检验进行描述。

结果

第一组987名婴儿中有695名(70.49%)被诊断为屈光不正,第二组65名婴儿中有49名(75.39%)被诊断为屈光不正。在未接受激光治疗而是接受保守治疗的987名婴儿组中,观察到远视和散光的发生率更高——分别为655名婴儿(66.33%)和202名婴儿(20.46%)。近视在接受激光治疗的婴儿组中最为常见:19例患者(29.23%)。该组中有9名婴儿(13.84%)存在散光。与保守治疗的婴儿组(分别为10.63%和1.63%)相比,斜视和眼球震颤形式的眼球位置紊乱在接受激光治疗的婴儿组中更为常见(分别为29.23%和9.23%)。

结论

在未发现病理性眼底病变或早产儿视网膜病变处于易于自行消退的低进展阶段的早产儿组中,远视和散光更为常见。近视在早产儿视网膜病变活动期以及需要进行激光治疗的婴儿组中更为常见。斜视和眼球震颤形式的眼球位置紊乱在接受二极管激光治疗的早产儿视网膜病变活动期婴儿组中更为频繁。

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