Chalam Kakarla V, Lin Selina, Murthy Ravi K, Brar Vikram S, Gupta Shailesh K, Radhakrishnan Ravi
Department of Ophthalmology, University of Florida School of Medicine, Jacksonville, FL, USA.
Middle East Afr J Ophthalmol. 2011 Jul;18(3):214-9. doi: 10.4103/0974-9233.84048.
The purpose was to determine if birth weight (BW) alone can be the sole criterion for screening infants at risk for retinopathy of prematurity (ROP).
In this retrospective, observational case series, 208 infants were screened for ROP using the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) Guidelines (1997). Variables examined included gestational age (GA), birth weight (BW), and a composite variable BWGA Index [(grams × weeks)/1000], which takes into consideration both the birth weight and gestational age of the infant. Infants were divided into two groups: Group 1, BW ≤1250 g, and Group 2, BW >1250 g. Multivariate analysis was performed to detect factors predictive of ROP. Receiver operator characteristic (ROC) curves were generated to determine the efficacy of screening using the BW, GA, and BWGA Index. Statistical analyses were performed with logistic regression with a P-value of 0.05 or less indicating statistical significance.
Varying stages of ROP were present in 116 of 416 eyes. Of the 105 eyes in Group 2, only 1 eye developed stage 1 ROP. Only Group 1 eyes developed stage 3 or higher ROP. The ROC curve for BW alone gave an area under the curve (AUC) of 0.797 (standard error [SE] = 0.0329, P < 0.0001); for GA, AUC was 0.801 (SE = 0.0340, P < 0.0001) and for the BWGA Index, the AUC was 0.808 (SE = 0.0324, P < 0.0001). Using 1250-g BW as a criterion for ROP screening would have decreased the number of screenings by 24%, and did not exclude any ROP higher than stage 1.
Data from our neonatal intensive care unit suggest that birth weight ≤ 1250 g alone is an adequate parameter to identify premature infants at risk for ROP.
确定仅出生体重（BW）能否作为筛查早产儿视网膜病变（ROP）高危婴儿的唯一标准。
在这个回顾性观察病例系列中，按照美国小儿眼科与斜视学会（AAPOS）指南（1997年）对208例婴儿进行ROP筛查。所检查的变量包括胎龄（GA）、出生体重（BW）以及一个综合变量BWGA指数[（克×周）/1000]，该指数同时考虑了婴儿的出生体重和胎龄。婴儿被分为两组：第1组，BW≤1250克；第2组，BW>1250克。进行多变量分析以检测ROP的预测因素。绘制受试者操作特征（ROC）曲线以确定使用BW、GA和BWGA指数进行筛查的效果。采用逻辑回归进行统计分析，P值小于或等于0.05表示具有统计学意义。
416只眼中有116只存在不同阶段的ROP。在第2组的105只眼中，仅有1只眼发生了1期ROP。只有第1组的眼睛发生了3期或更高期的ROP。仅BW的ROC曲线下面积（AUC）为0.797（标准误[SE]=0.0329，P<0.0001）；GA的AUC为0.801（SE=0.0340，P<0.0001），BWGA指数的AUC为0.808（SE=0.0324，P<0.0001）。以1250克BW作为ROP筛查标准可减少24%的筛查次数，且不会排除任何高于1期的ROP。
我们新生儿重症监护病房的数据表明，仅出生体重≤1250克是识别ROP高危早产儿的一个充分参数。
