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早产儿视网膜病变患儿长期不良眼部预后的危险因素分析

Risk factor analysis for long-term unfavorable ocular outcomes in children treated for retinopathy of prematurity.

作者信息

Mutlu Fatih Mehmet, Küçükevcilioğlu Murat, Ceylan Osman Melih, Altınsoy Halil Ibrahim, Sarıcı S Umit

机构信息

Department of Ophthalmology, Gülhane Military Medical Academy and School of Medicine, Ankara, Turkey.

出版信息

Turk J Pediatr. 2013 Jan-Feb;55(1):35-41.

PMID:23692830
Abstract

The aim in this study was to report long-term ocular outcomes of neonates treated for retinopathy of prematurity (ROP) and potential risk factors for unfavorable ocular outcomes. The study consisted of neonates treated for ROP between March 1999 and November 2009. Data relating baseline characteristics and late structural, functional and refractive ocular outcomes were recorded. The association between the unfavorable ocular outcomes and ROP-related risk factors was evaluated by regression analysis. Forty-eight children were included for assessment. Average chronological age at the time of followup was 3.11±0.73 years. The rates of unfavorable structural and functional outcomes were 12% and 15.3%, respectively. Ocular deviation was common (27.1%), and mostly esotropic (12/13). A clear myopic tendency was observed (51.2%), and the mean spherical equivalent per eye was -0.72±2.9 diopters. Regression analyses for unfavorable ocular outcomes revealed intraventricular hemorrhage as a core independent risk factor. In conclusion, ROP treatment has shown promising results in both structure and function. Because of the high risk of developing an unfavorable outcome, a more intense follow-up is required in neonates with a history of intraventricular hemorrhage in the neonatal period. Further studies from other centers are needed to develop a national database, which may validate this observation.

摘要

本研究旨在报告接受早产儿视网膜病变(ROP)治疗的新生儿的长期眼部结局以及不良眼部结局的潜在风险因素。该研究纳入了1999年3月至2009年11月期间接受ROP治疗的新生儿。记录了与基线特征以及晚期眼部结构、功能和屈光结局相关的数据。通过回归分析评估不良眼部结局与ROP相关风险因素之间的关联。共有48名儿童纳入评估。随访时的平均实足年龄为3.11±0.73岁。不良结构和功能结局的发生率分别为12%和15.3%。眼位偏斜很常见(27.1%),且大多为内斜视(12/13)。观察到明显的近视倾向(51.2%),每只眼睛的平均等效球镜度为-0.72±2.9屈光度。对不良眼部结局的回归分析显示,脑室内出血是一个核心独立风险因素。总之,ROP治疗在结构和功能方面均显示出有前景的结果。由于发生不良结局的风险较高,对于新生儿期有脑室内出血病史的新生儿需要更密切的随访。需要其他中心开展进一步研究以建立一个全国性数据库,这可能会验证这一观察结果。

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Graefes Arch Clin Exp Ophthalmol. 2022 Oct;260(10):3213-3219. doi: 10.1007/s00417-022-05663-0. Epub 2022 May 12.
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Refractive status and optical components of premature babies with or without retinopathy of prematurity at 7 years old.7岁时患有或未患早产儿视网膜病变的早产儿的屈光状态和眼部光学组件
Transl Pediatr. 2020 Apr;9(2):108-116. doi: 10.21037/tp.2020.03.01.
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Retinopathy of prematurity: a review of risk factors and their clinical significance.
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Surv Ophthalmol. 2018 Sep-Oct;63(5):618-637. doi: 10.1016/j.survophthal.2018.04.002. Epub 2018 Apr 19.