Grunwald Lili, Mills Monte D, Johnson Keegan S, Karp Karen A, Quinn Graham E, Ying Gui-Shuang, Grunwald Juan E
Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Am J Ophthalmol. 2009 Jun;147(6):1086-91, 1091.e1-2. doi: 10.1016/j.ajo.2008.12.038. Epub 2009 Mar 16.
To assess whether the rate of change of retinal vessel diameter can help identify infants at the highest risk for severe retinopathy of prematurity (ROP).
Thirty-five infants at risk for ROP were included in this prospective, longitudinal study.
Images were obtained using the NIDEK NM200D noncontact camera (NIDEK Inc, Aichi, Japan) at the time of ROP examinations in the intensive care unit. Vessel diameters were measured from digital fundus photographs of right eyes in a masked fashion using VesselMap image analysis software (IM-EDOS GmbH, Weimar, Germany). The rate of change of vessel diameter was calculated based on the linear regression slope and was compared between eyes in which type 1 ROP requiring treatment developed and in controls without ROP or with ROP less severe than type 1.
Multivariate analysis showed that the group of eyes in which type 1 ROP developed had a greater increase in diameter over time in the inferior temporal veins (P = .01), superior temporal veins (P < .0001), mean temporal veins (P < .0001), superior temporal arteries (P = .02), and mean temporal arteries (P = .004). The area under receiver operator characteristic curve for venous diameter change was 0.96 for the superior temporal vein, 0.86 for the inferior temporal vein, and 0.96 for the mean temporal vein.
On average, the rate of retinal vessel change was greater in eyes with type 1 ROP requiring treatment than in control eyes. The rate of venous diameter change had the best discriminative ability to differentiate between the 2 groups.
评估视网膜血管直径的变化率是否有助于识别发生重度早产儿视网膜病变(ROP)风险最高的婴儿。
35名有ROP风险的婴儿纳入了这项前瞻性纵向研究。
在重症监护病房进行ROP检查时,使用NIDEK NM200D非接触式相机(日本爱知县NIDEK公司)获取图像。使用VesselMap图像分析软件(德国魏玛IM-EDOS有限公司)以盲法从右眼的数字眼底照片测量血管直径。基于线性回归斜率计算血管直径变化率,并在发生需要治疗的1型ROP的眼与无ROP或患有比1型轻的ROP的对照眼之间进行比较。
多变量分析显示,发生1型ROP的眼组中,颞下静脉(P = 0.01)、颞上静脉(P < 0.0001)、颞平均静脉(P < 0.0001)、颞上动脉(P = 0.02)和颞平均动脉(P = 0.004)随时间的直径增加更大。颞上静脉直径变化的受试者操作特征曲线下面积为0.96,颞下静脉为0.86,颞平均静脉为0.96。
平均而言,发生需要治疗的1型ROP的眼的视网膜血管变化率高于对照眼。静脉直径变化率在区分两组方面具有最佳判别能力。