Mehmet Sariaydin, Fusun Atlihan, Sebnem Calkavur, Ozgur Olukman, Gulten Ercan, Taylan Ozturk Arif, Fatma Kaya Kilic, Filiz Gokaslan, Derya Altinyaprak, Rana Malatyali
Department of Neonatology, Trabzon Medical Faculty, Izmir, Turkey.
Int J Ophthalmol. 2011;4(6):634-40. doi: 10.3980/j.issn.2222-3959.2011.06.12. Epub 2011 Dec 18.
As a result of the increase in premature births and the advances in neonatal intensive care, retinopathy of prematurity (ROP) remains one of the most important causes of childhood blindness worldwide. The main factors in the development of ROP are gestational age, birth weight and oxygen therapy. ROP continues to gain importance due to the increasing survival rates of more immature babies.
Between January 2007 and October 2008, 203 premature infants treated at the Neonatal Intensive Care Unit (NNICU) were prospectively enrolled and the relationship between known risk factors and the occurance of ROP was studied.
ROP in various stages developed in 86 cases (42.4%). Statistically significant correlations were found between the development of ROP and birth weight (P<0.0001) gestational age (P<0.0001), oxygen treatment and its duration (P<0.0001 and P=0.002), mechanical ventilation (MV) and its duration (P=0,0001 and P=0.0001), apnea (P=0.001), intraventricular hemorrhage (IVH) (P=0.046), sepsis (P=0.0001), use of erythropoietin (EPO) (P=0.003), the number of blood transfusions and frequency (P=0.0001 and P=0.0001), surfactant application (P=0.0001), the presence of patent ductus arteriosus (PDA) (P=0.001) or bronchopulmonary dysplasia (BPD) (P=0.0001). No significant correlations were found between the occurance of ROP and maternal pre-eclampsia (P=0.293), multiple pregnancy (P=0.218), or hyperbilirubinemia (P=0.494). Severity of ROP was related significantly with birth weight (P=0.0001), but no significant correlation between severity of ROP and gestational age was present.
Early description and reduction of the risk factors related with the occurance of ROP with the help of routine screening programs may warrant the prevention of visual loss, however early ophthalmic diagnosis and treatment are still mandatory to provide better visual rehabilitation.
由于早产率上升以及新生儿重症监护技术的进步,早产儿视网膜病变(ROP)仍是全球儿童失明的最重要原因之一。ROP发生发展的主要因素包括胎龄、出生体重和氧疗。随着越来越多未成熟婴儿存活率的提高,ROP的重要性持续增加。
2007年1月至2008年10月,前瞻性纳入在新生儿重症监护病房(NNICU)接受治疗的203例早产儿,研究已知风险因素与ROP发生之间的关系。
86例(42.4%)出现不同阶段的ROP。发现ROP的发生与出生体重(P<0.0001)、胎龄(P<0.0001)、氧疗及其持续时间(P<0.0001和P=0.002)、机械通气(MV)及其持续时间(P=0.0001和P=0.0001)、呼吸暂停(P=0.001)、脑室内出血(IVH)(P=0.046)、败血症(P=0.0001)、促红细胞生成素(EPO)的使用(P=0.003)、输血次数和频率(P=0.0001和P=0.0001)、表面活性剂应用(P=0.0001)、动脉导管未闭(PDA)的存在(P=0.001)或支气管肺发育不良(BPD)(P=0.0001)之间存在统计学显著相关性。未发现ROP的发生与母亲先兆子痫(P=0.293)、多胎妊娠(P=0.218)或高胆红素血症(P=0.494)之间存在显著相关性。ROP的严重程度与出生体重显著相关(P=0.0001),但ROP严重程度与胎龄之间无显著相关性。
借助常规筛查程序早期描述并降低与ROP发生相关的风险因素可能有助于预防视力丧失,然而早期眼科诊断和治疗对于提供更好的视力康复仍然必不可少。