Bonotto Lígia Beatriz, Moreira Ana Tereza Ramos, Bortolotto Cristina Martins Faria
Hospital Sadalla Amin Ghanem e UTI Neonatal da UNIMED, Joinville (SC), Brasil.
Arq Bras Oftalmol. 2013 Mar-Apr;76(2):98-104. doi: 10.1590/s0004-27492013000200009.
Compare the retinal structure of the macula and fovea among premature infants with retinopathy of prematurity (ROP) stages II and III post treatment, premature infants with ROP stages II and III with spontaneous regression and premature infants without ROP, through optical coherence tomography (OCT) and binocular indirect ophthalmoscopy (BIO) examinations.
Cross-sectional observational and not-blinded study. There were included premature infants born between 06/1992 and 06/2006 and examined between 06/2009 and 12/2010; gestational age less than or equal to 32 weeks and birth weight less than or equal to 1,599 g; with a minimum of three visits during the selection period; without retinopathy of prematurity, or with the diagnosis of ROP stages II or III in at least one eye with spontaneous regression or after ROP treatment; maximum of six months of chronological age for the first examination at the service; minimal chronological age of four years old in the reassessment period. There were excluded premature infants who did not attend or did not have clinical conditions for the reassessment examination. The premature infants were divided into three groups: G1 - with ROP post-treatment; G2 - with ROP post-spontaneous regression; and G3 - without ROP. The exams performed were BIO and OCT.
Twenty-four premature infants (48 eyes) presented the criteria required for the research, chronological age ranging from 5 to 6 years. At BIO, there was a statistically significant difference for the presence of alterations in the retina of premature infants from group G1. However these changes corresponded to the cicatricial lesions left by the ROP treatment, without visible impairment to the macular region. At OCT there were statistically significant differences for the greatest foveal thickness between premature infants from groups G1 and G2. Considering the left eye, there was no statistically significant difference related to the thickness of the fovea between G1 and G3. There was no difference among the three groups studied in relation to the changes of the retinal layers at OCT.
Premature infants with ROP post-treatment showed foveal thickness greater than premature infants with ROP post-spontaneous regression; and foveal thickness similar to premature infants without ROP in relation to assessment of the left eye. Regarding the changes of the retinal layers detected at OCT, the three groups were similar, without expression of difference for the treated group in this study.
通过光学相干断层扫描(OCT)和双目间接检眼镜检查(BIO),比较接受治疗的早产儿视网膜病变(ROP)II期和III期、ROP II期和III期自行消退的早产儿以及无ROP的早产儿黄斑和中央凹的视网膜结构。
横断面观察性非盲研究。纳入1992年6月至2006年6月出生、2009年6月至2010年12月接受检查的早产儿;胎龄小于或等于32周,出生体重小于或等于1599克;在入选期间至少进行三次访视;无早产儿视网膜病变,或至少一只眼诊断为ROP II期或III期且自行消退或接受ROP治疗后;首次在该机构检查时实际年龄最大为6个月;复查期实际年龄最小为4岁。排除未参加或无复查临床条件的早产儿。将早产儿分为三组:G1组 - ROP治疗后;G2组 - ROP自行消退后;G3组 - 无ROP。进行的检查为BIO和OCT。
24名早产儿(48只眼)符合研究所需标准,实际年龄为5至6岁。在BIO检查中,G1组早产儿视网膜病变的存在有统计学显著差异。然而,这些变化对应于ROP治疗留下的瘢痕性病变,黄斑区域未见明显损害。在OCT检查中,G1组和G2组早产儿之间中央凹最大厚度有统计学显著差异。考虑左眼,G1组和G3组中央凹厚度无统计学显著差异。在OCT检查中,三组视网膜层变化无差异。
接受治疗的ROP早产儿中央凹厚度大于ROP自行消退的早产儿;就左眼评估而言,中央凹厚度与无ROP的早产儿相似。关于OCT检测到的视网膜层变化,三组相似,本研究中治疗组无差异表现。