Nie Wen-ying, Wu Han-rong, Qi Yi-sheng, Zhang Min, Hou Qian, Yang Hai-xia, Gong Lu-xia, Dong Yan-ru, Guo Yu-luan, Shi Jin-na, Yin Su-ying, Li Ping-yu
Department of Child and Adolescent Health & Maternal and Child Health Care, School of Public Health, Tongji Medical College of Huazhong University of Science & Technology, Wuhan 430030, China.
Zhonghua Yan Ke Za Zhi. 2008 Jun;44(6):497-502.
To explore the clinical strategies for the screening of newborn eye diseases and obtain information concerning the incidence of newborn ocular diseases.
Newborns in a baby-friendly nursery were evaluated for mass screening of eye diseases 2 to 7 days after birth (including reaction to light stimulation, external ocular examination and test for pupil red reflex) and those with abnormalities were subjected to diagnostic examination (external ocular examination with a hand-held slit-lamp, pupil red reflex and mydriatic examination). Newborns in neonatal intensive care unit (NICU) were subjected to screening 5 to 14 days after birth and then, together with those with high risk factors, received a comprehensive examination for screening and diagnostic purposes. The suspected cases were referred to department of ophthalmology for definite diagnosis.
Among the 15,398 (91.65%) newborns who were enrolled the screening program, 12 different eye diseases (involving 1266 cases) were detected, with a prevalence of 8.22%. Of these eye diseases, 7 were congenital ocular diseases, involving 809 cases (5. 254%) and including congenital ptosis in 2 cases (0.013%), congenital corneal opacity in 6 cases (0.039%), persistent pupillary membrane in 724 cases (4.702%), congenital cataract in 15 cases (0.097%), persistent hyaloid artery in 54 cases (0.351%), obstruction of nasolacrimal duct in 7 cases (0.046%) and lacrimal gland prolapse in 1 cases (0.007%). Five different diseases (457 cases, 2. 968%) detected were acquired in nature, including neonatal conjunctivitis in 391 case (2.539%), vitreous hemorrhage in 6 cases (0.039%), retinal hemorrhage in 34 cases (0.221%), and neonatal dacryocystitis in 23 cases (0.149%). Of 27 premature babies with body weight lower than 1500 g, 3 had retinopathy of prematurity (ROP, 6 eyes involved).
Early intervention is of great importance for the prevention and treatment of neonatal ocular diseases. The screening of newborn ocular diseases is not only feasible but also effective in the monitoring and control of the eye diseases in neonates.
探讨新生儿眼病筛查的临床策略，并获取新生儿眼部疾病发病率的相关信息。
对母婴同室病房的新生儿在出生后2至7天进行眼病大规模筛查（包括光刺激反应、眼部外观检查及瞳孔红光反射检查），对检查异常者进行诊断性检查（手持裂隙灯进行眼部外观检查、瞳孔红光反射及散瞳检查）。新生儿重症监护病房（NICU）的新生儿在出生后5至14天进行筛查，然后与有高危因素的新生儿一起接受全面检查以进行筛查和诊断。疑似病例转诊至眼科进行明确诊断。
在纳入筛查项目的15398名（91.65%）新生儿中，检测出12种不同的眼病（涉及1266例），患病率为8.22%。其中，7种为先天性眼病，涉及809例（5.254%），包括先天性上睑下垂2例（0.013%）、先天性角膜混浊6例（0.039%）、永存瞳孔膜724例（4.702%）、先天性白内障15例（0.097%）、永存玻璃体动脉54例（0.351%）、鼻泪管阻塞7例（0.046%）及泪腺脱垂1例（0.007%）。检测出的5种不同的后天性疾病（457例，2.968%），包括新生儿结膜炎391例（2.539%）、玻璃体出血6例（0.039%）、视网膜出血34例（0.221%）及新生儿泪囊炎23例（0.149%）。在27名体重低于1500g的早产儿中，3例患有早产儿视网膜病变（ROP，累及6只眼）。
早期干预对新生儿眼病的防治至关重要。新生儿眼病筛查在监测和控制新生儿眼病方面不仅可行而且有效。
