Department of Ophthalmology, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan.
J Formos Med Assoc. 2013 Aug;112(8):445-53. doi: 10.1016/j.jfma.2012.03.002. Epub 2012 May 5.
BACKGROUND/PURPOSE: Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. This retrospective study investigated ROP, including incidence, demographic information,risk factors, treatments, and refractive outcomes, in southern Taiwan over a 10-year period.
The authors retrieved the National Cheng Kung University Hospital database between the years 2000 and 2009 for newborns with a gestational age less than 32 weeks and/or with a birth weight less than 1500 g who had been screened for ROP. We recorded sex, birth weight, gestational age, in-hospital versus out-of-hospital birth, paternal and maternal ages, whether there were multiple gestations, parity, Apgar scores, length of hospital stay, risk factors, presence and severity of ROP and whether it was treated, and refraction at the last visit. Regression analyses were performed to identify risk factors for ROP.
A total of 503 live births were included. ROP was identified in 190 (37.8%) and met criteria for treatment in 59 (11.7%).ROP was diagnosed as stage 1, 2, 3, 4, and 5 in 61 (12.1%), 36 (7.2%), 81 (16.1%), 11 (2.2%), and 1 (0.2%) infant, respectively. Lower birth weight and younger gestational age were risk factors for greater severity of ROP (p < 0.001). Of the 167 with extremely low birth weight (<1000 g), 118 (70.7%) had ROP and 49 (29.3%) required treatment. On univariate analysis, low birth weight, younger gestational age, and risk factors such as respiratory distress syndrome, chronic lung disease, patent ductus arteriosus, surfactant usage, indomethacin usage, sepsis, upper gastrointestinal bleeding, blood transfusion, and necrotizing enterocolitis were associated with ROP. Multivariate logistic regression analysis showed that only lower birth weight was a significant and independent risk factor for ROP. Myopia (76%)and anisometropia (28%)were common in advanced ROP.
Low birth weight is a major risk factor for ROP. Infants with extremely low birth weight had a higher risk of severe ROP. Common ocular sequelae of advanced ROP were myopia and anisometropia.
背景/目的：早产儿视网膜病变（ROP）是儿童失明的主要原因。本回顾性研究调查了台湾南部 10 年来 ROP 的发病情况、人口统计学信息、危险因素、治疗方法和屈光不正结果。
作者检索了 2000 年至 2009 年国立成功大学医院的数据库，其中包括胎龄小于 32 周和/或出生体重小于 1500 克的新生儿，这些新生儿均接受了 ROP 筛查。作者记录了性别、出生体重、胎龄、院内或院外出生、父母年龄、是否为多胎妊娠、产次、阿普加评分、住院时间、危险因素、ROP 的存在和严重程度以及是否接受治疗以及最后一次就诊时的屈光状态。采用回归分析确定 ROP 的危险因素。
共纳入 503 例活产儿。190 例（37.8%）确诊为 ROP，59 例（11.7%）符合治疗标准。ROP 分别诊断为 1 期、2 期、3 期、4 期和 5 期的患儿分别为 61 例（12.1%）、36 例（7.2%）、81 例（16.1%）、11 例（2.2%）和 1 例（0.2%）。出生体重越低、胎龄越小，ROP 越严重（p<0.001）。在 167 例极低出生体重（<1000 克）的婴儿中，118 例（70.7%）患有 ROP，49 例（29.3%）需要治疗。单因素分析显示，低出生体重、较小的胎龄以及呼吸窘迫综合征、慢性肺疾病、动脉导管未闭、表面活性剂使用、吲哚美辛使用、败血症、上消化道出血、输血和坏死性小肠结肠炎等危险因素与 ROP 相关。多因素 logistic 回归分析显示，只有低出生体重是 ROP 的显著且独立的危险因素。ROP 晚期常见的眼部后遗症为近视（76%）和屈光参差（28%）。
低出生体重是 ROP 的主要危险因素。极低出生体重儿患严重 ROP 的风险更高。ROP 晚期常见的眼部后遗症为近视和屈光参差。
