Martínez-Cruz Carlos F, Salgado-Valladares Manuel, Poblano Adrián, Trinidad-Pérez María C
Departamento de Pediatría de seguimiento, Instituto Nacional de Perinatología Dr. Isidro Espinosa de los Reyes.
Rev Invest Clin. 2012 Mar-Apr;64(2):136-43.
Retinopathy of prematurity (RoP) is a retinal vascular disease and a frequent cause of blindness in infants. Our objective was to measure the frequency of RoP in infants with extremely low birth weight (ELBW, < 1,000 g) at the National Institute of Perinatology, Neonatal Intensive Care Unit (NICU), weighing the association of RoP with several risk factors and their results, such as refractive errors and strabismus.
We carried out two cross-sectional observations of our prospective study: one near birth, and the second, after a long-term follow-up. Funduscopic examination was performed while the infants were in the NICU to detect RoP. Infants with RoP were followed up by means of visual examinations during an average 8-year period and results were compared with those of infants with ELBW without RoP.
Of the 139 screened infants at the NICU, 24.4% were identified with RoP: 79% of these with grade I retinopathy; 18% with grade II, and one infant with grade III retinopathy. The zones involved were as follows: zone 1, 12%; zone 2, 79%, and zone 3, 9%. The following were associated with retinopathy: eclampsia (p = 0.003); gestational age (0.01); multiple gestation (0.03); days of stay at NICU (< 0.001); mechanical ventilation (0.001); hypoxia (0.01); oxygen therapy (< 0.001); apnea (0.005); acidosis (0.001), and hypercapnia (0.001). Retinopathy was self-limited in all children. We found no differences in frequency of refractive errors and strabismus between children with RoP and controls.
We observed a moderately high frequency of RoP in infants with ELBW in Mexico City and recommended early mandatory screening for early intervention.
早产儿视网膜病变（RoP）是一种视网膜血管疾病，是婴儿失明的常见原因。我们的目的是在国家围产医学研究所新生儿重症监护病房（NICU）测量极低出生体重（ELBW，<1000g）婴儿中RoP的发生率，权衡RoP与多种危险因素及其结果（如屈光不正和斜视）之间的关联。
我们对前瞻性研究进行了两次横断面观察：一次在出生时，另一次在长期随访后。在婴儿入住NICU期间进行眼底检查以检测RoP。对患有RoP的婴儿进行平均8年的视力检查随访，并将结果与无RoP的ELBW婴儿的结果进行比较。
在NICU筛查的139名婴儿中，24.4%被诊断为RoP：其中79%为I级视网膜病变；18%为II级，1名婴儿为III级视网膜病变。受累区域如下：1区，12%；2区，79%，3区，9%。以下因素与视网膜病变相关：子痫（p = 0.003）；胎龄（0.01）；多胎妊娠（0.03）；在NICU的住院天数（<0.001）；机械通气（0.001）；缺氧（0.01）；氧疗（<0.001）；呼吸暂停（0.005）；酸中毒（0.001）和高碳酸血症（0.001）。所有儿童的视网膜病变均为自限性。我们发现患有RoP的儿童与对照组在屈光不正和斜视的发生率上没有差异。
我们在墨西哥城的ELBW婴儿中观察到RoP的发生率中等偏高，并建议进行早期强制筛查以便早期干预。
