Lee Ji Eun, Park Jun Mo, Choi Hee Young, Oum Boo Sup
Department of Ophthalmology, Medical Research Institute, Pusan National University School of Medicine, Busan, Korea.
Korean J Ophthalmol. 2012 Jun;26(3):189-94. doi: 10.3341/kjo.2012.26.3.189. Epub 2012 May 22.
Bell's phenomenon (BP), which may disturb screening examinations for retinopathy of prematurity (ROP), is known to present infrequently in premature babies. Stress associated with the examinations can influence expression of BP. The authors of the present study evaluated BP during examinations for ROP.
The present study included 102 eyes of 51 premature babies. Expression of BP was assessed at 3 steps of the examination in the following order: after insertion of a speculum, after illumination of an indirect ophthalmoscope and after scleral depression. The relationship between the expression of BP and the gestational age at the examination was analyzed in each step of the examination.
The frequency of BP after the speculum insertion and the illumination was 77% to 92% in infants 32 weeks of age or younger, and decreased significantly to 16% to 57% in infants 42 weeks of age or older (p < 0.005). BP after the scleral depression had no significant association with the gestational age. Frequency of BP increased significantly as the steps of the examination proceeded (p < 0.01).
BP was frequent in premature infants during ROP examination in spite of neurological immaturity. The examiner should take BP into consideration, which frequently occurs in younger infants.
贝尔现象（BP）可能会干扰早产儿视网膜病变（ROP）的筛查检查，已知在早产儿中很少出现。检查相关的压力会影响BP的表现。本研究的作者评估了ROP检查期间的BP。
本研究纳入了51例早产儿的102只眼。按照以下顺序在检查的3个步骤评估BP的表现：插入窥器后、间接检眼镜照明后和巩膜压迫后。在检查的每个步骤中分析BP表现与检查时胎龄之间的关系。
32周龄及以下婴儿在插入窥器和照明后BP出现频率为77%至92%，而42周龄及以上婴儿显著降至16%至57%（p<0.005）。巩膜压迫后BP与胎龄无显著关联。随着检查步骤的推进，BP出现频率显著增加（p<0.01）。
尽管神经发育不成熟，但ROP检查期间早产儿中BP很常见。检查者应考虑到BP在较小婴儿中经常出现的情况。
