Alme Aaron M, Mulhern Michael L, Hejkal Thomas W, Meza Jane L, Qiu Fang, Ingvoldstad David D, Margalit Eyal
University of Nebraska Medical Center, Department of Ophthalmology and Visual Sciences, Omaha, Nebraska, USA.
BMC Ophthalmol. 2008 Nov 13;8:23. doi: 10.1186/1471-2415-8-23.
The Early Treatment for Retinopathy of Prematurity study (ETROP), published in 2003, established new guidelines for treatment of retinopathy of prematurity (ROP) and demonstrated improved outcomes compared to previous guidelines. We examined outcomes before and after implementing the ETROP recommendations.
A retrospective chart review was performed using records of infants who had laser ablations for ROP performed from January, 2000 through December, 2005. Data collected included date of birth; birth weight; estimated gestational age (EGA); grading of ROP; date of laser ablation; and outcome of laser surgery. Univariate association with threshold or prethreshold treatment (Pre-ETROP and Post-ETROP, respectively) were assessed using t-tests or Wilcoxon tests. Additional comparison between groups was performed using Fisher's exact tests.
581 patients were examined before and 464 after December 2003. Of these, 29/581 (5% - Pre-ETROP Group) and 53/464 (11% - Post-ETROP Group) patients advanced to criteria requiring laser treatment respectively (P = 0.0001). The average estimated gestational age (EGA) at birth was 26.3 and 25.2 weeks, with an average birth weight of 888 and 707 grams for Pre and Post-ETROP Groups, respectively. Stage 5 retinal detachment (RD) developed in 10.3% of eyes in the Pre-ETROP Group and 1.9% of eyes in the Post-ETROP Group (P = 0.02).
After the ETROP guidelines were implemented, there was a decrease from 10.3% to 1.9% of eyes developing Stage 5 retinal detachment, despite this group having a lower average EGA and lower average birth weight. These results underscore the importance of adoption of the Revised Indications.
2003年发表的早产儿视网膜病变早期治疗研究（ETROP）建立了早产儿视网膜病变（ROP）的新治疗指南，并显示与以前的指南相比，治疗效果有所改善。我们研究了实施ETROP建议前后的治疗效果。
使用2000年1月至2005年12月期间接受ROP激光消融治疗的婴儿记录进行回顾性图表审查。收集的数据包括出生日期、出生体重、估计孕周（EGA）、ROP分级、激光消融日期和激光手术结果。使用t检验或Wilcoxon检验评估与阈值或阈值前治疗（分别为ETROP前和ETROP后）的单变量关联。使用Fisher精确检验在组间进行额外比较。
2003年12月之前检查了581例患者，之后检查了464例患者。其中，分别有29/581（5% - ETROP前组）和53/464（11% - ETROP后组）的患者进展到需要激光治疗的标准（P = 0.0001）。ETROP前组和ETROP后组出生时的平均估计孕周（EGA）分别为26.3周和25.2周，平均出生体重分别为888克和707克。ETROP前组10.3%的眼睛发生了5期视网膜脱离（RD），ETROP后组为1.9%（P = 0.02）。
实施ETROP指南后，发生5期视网膜脱离的眼睛比例从10.3%降至1.9%，尽管该组的平均EGA和平均出生体重较低。这些结果强调了采用修订后的适应症的重要性。
