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预防早产儿视网膜病变致盲:一项全国性行动。

Prevention of blindness due to retinopathy of prematurity: a national movement.

作者信息

Azad Rajvardhan

机构信息

Department of Ophthalmology, Vitreo-Retina and Ocular Trauma Unit, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Indian Institute of Medical Sciences, New Delhi, 110029, India,

出版信息

Indian J Pediatr. 2014 Dec;81(12):1373-5. doi: 10.1007/s12098-014-1411-x. Epub 2014 May 4.

Abstract

Retinopathy of Prematurity (ROP) has been a blinding disorder and a preventable cause of childhood blindness. With growing interest in pediatric ophthalmology and vitreo-retinal subspecialty, ROP has become increasingly recognized in India. Recently, with rise in number of children admitted to NICU's across India, there has been an increase in number of preterm babies with ROP due to variable neonatal practices. An effort to prevent the disease was taken up by WHO and Ministry of Health & Family Welfare by conducting workshops across India piloted by R.P. Centre, AIIMS. These workshops have gone a long way in spreading awareness amongst both neonatologists and ophthalmologists in paired sessions. Both neonatologists and ophthalmologists complemented each other, discussed ROP prevention and issued ROP screening and good neonatal care guidelines which were different from the American guidelines. Treatment strategies have also undergone a huge change from cryotherapy and laser to anti-vascular endothelial growth factor (Anti-VEGF) drugs which have shown promising results, although caution is to be taken due to lack of data on long-term safety. Overall impact of these workshops led to inclusion of ROP in priority list of blindness control programme of Government of India. Still, ROP prevention needs integration of both governmental and non-governmental agencies, each sharing the load in a complementing way aiding in downward trends of ROP cases.

摘要

早产儿视网膜病变(ROP)一直是一种致盲性疾病,也是儿童失明的一个可预防原因。随着对小儿眼科和玻璃体视网膜亚专业的兴趣日益浓厚,ROP在印度越来越受到认可。最近,随着印度各地新生儿重症监护病房(NICU)收治儿童数量的增加,由于新生儿护理方式的差异,患ROP的早产儿数量有所上升。世界卫生组织(WHO)和卫生与家庭福利部通过由全印度医学科学研究所(AIIMS)R.P.中心牵头在印度各地举办研讨会,努力预防这种疾病。这些研讨会在为新生儿科医生和眼科医生举办的配对会议中,在提高认识方面发挥了很大作用。新生儿科医生和眼科医生相互补充,讨论了ROP的预防,并发布了与美国指南不同的ROP筛查和优质新生儿护理指南。治疗策略也经历了巨大变化,从冷冻疗法和激光治疗转变为抗血管内皮生长因子(Anti-VEGF)药物,尽管由于缺乏长期安全性数据需要谨慎使用,但这些药物已显示出有希望的结果。这些研讨会的总体影响导致ROP被列入印度政府失明控制计划的优先名单。尽管如此,ROP的预防仍需要政府和非政府机构的整合,各方以互补的方式分担责任,以帮助减少ROP病例的数量。

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