早产儿视网膜病变早期治疗研究至 6 岁时的散光进展。
Astigmatism progression in the early treatment for retinopathy of prematurity study to 6 years of age.
机构信息
Departments of Ophthalmology and Pediatrics, Cardinal Glennon Children's Medical Center, Saint Louis University School of Medicine, St Louis, Missouri 63104, USA.
出版信息
Ophthalmology. 2011 Dec;118(12):2326-9. doi: 10.1016/j.ophtha.2011.06.006. Epub 2011 Aug 27.
PURPOSE
To examine the prevalence of astigmatism (≥ 1.00 diopter [D]) and high astigmatism (≥ 2.00 D) from 6 months after term due date to 6 years of age in preterm children with birth weight of less than 1251 g in whom high-risk prethreshold retinopathy of prematurity (ROP) developed and who participated in the Early Treatment for ROP study.
DESIGN
Observational cohort study.
PARTICIPANTS
Four hundred one infants in whom high-risk prethreshold ROP developed in 1 or both eyes and were randomized to early treatment (ET) versus conventional management (CM). Refractive error was measured by cycloplegic retinoscopy. Eyes were excluded if they underwent additional retinal, glaucoma, or cataract surgery.
INTERVENTION
Eyes were randomized to receive laser photocoagulation at high-risk prethreshold ROP or to receive treatment only if threshold ROP developed.
MAIN OUTCOME MEASURES
Astigmatism and high astigmatism at each study visit.
RESULTS
For both ET and CM eyes, there was a consistent increase in prevalence of astigmatism over time, increasing from 42% at 4 years to 52% by 6 years for the group of ET eyes and from 47% to 54%, respectively, in the CM eyes. There was no statistically significant difference between the slopes (rate of change per month) of the ET and CM eyes for both astigmatism and high astigmatism (P = 0.75).
CONCLUSIONS
By 6 years of age, astigmatism of 1.00 D or more developed in more than 50% of eyes with high-risk prethreshold ROP, and nearly 25% of such eyes had high astigmatism (≥ 2.00 D). Presence of astigmatism was not influenced by timing of treatment, zone of acute-phase ROP, or presence of plus disease. However, there was a trend toward higher prevalence of astigmatism and high astigmatism in eyes with ROP residua. Most astigmatism was with-the-rule (75°-105°). More eyes with type 2 than type 1 ROP had astigmatism by 6 years. These findings reinforce the need for follow-up eye examinations through early grade school years in infants with high-risk prethreshold ROP.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
目的
研究出生体重＜1251g 的早产儿，在高危阈前早产儿视网膜病变（ROP）发生后 6 个月至 6 岁时，散光（≥1.00 屈光度[D]）和高度散光（≥2.00 D）的发生率。这些早产儿接受了早期治疗 ROP（ETROP）研究。
设计
观察性队列研究。
参与者
401 名婴儿，双眼均有 1 只或 1 只以上眼出现高危阈前 ROP，并随机分为早期治疗（ET）组或常规治疗（CM）组。通过睫状肌麻痹视网膜检影术测量屈光不正。如果眼睛接受了额外的视网膜、青光眼或白内障手术，则将其排除在外。
干预措施
眼随机接受高危阈前 ROP 的激光光凝治疗，或仅在阈值 ROP 发生时接受治疗。
主要观察指标
各研究访视时的散光和高度散光。
结果
对于 ET 眼和 CM 眼，散光的发生率随时间呈持续增加趋势，ET 眼组从 4 岁时的 42%增加到 6 岁时的 52%，CM 眼组从 47%增加到 54%。ET 眼和 CM 眼的散光和高度散光斜率（每月变化率）之间无统计学差异（P=0.75）。
结论
到 6 岁时，高危阈前 ROP 眼有 50%以上发展为 1.00 D 或更高的散光，近 25%的此类眼有高度散光（≥2.00 D）。散光的存在不受治疗时机、急性期 ROP 区和 PLUS 病的影响。然而，ROP 残余病变的眼有较高的散光和高度散光发生率趋势。大多数散光为顺规散光（75°-105°）。6 岁时，2 型 ROP 眼比 1 型 ROP 眼有更多的散光。这些发现强调了需要对高危阈前 ROP 婴儿进行早期至小学阶段的随访眼部检查。
利益冲突披露
作者在本文讨论的任何材料中均没有所有权或商业利益。
Zotero 插件