较大及近期出生婴儿的视网膜病变：一组罕见病例
Larger and near-term baby retinopathy: a rare case series.
作者信息
Padhi T R, Rath S, Jalali S, Pradhan L, Kesarwani S, Nayak M, Mishra B, Panda K G, Suttar S
机构信息
Retina-Vitreous Services, L V Prasad Eye Institute, Bhubaneswar, India.
Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, L V Prasad Eye Institute, Hyderabad, India.
出版信息
Eye (Lond). 2015 Feb;29(2):286-9. doi: 10.1038/eye.2014.253. Epub 2014 Oct 31.
PURPOSE
To report retinopathy in a series of four babies unusually beyond the screening standards reported so far in the literature.
METHODS
During routine screening for retinopathy of prematurity, we detected retinopathy in four babies who were surprisingly bigger and older than the screening standards. The gestational age (GA), birth weight (BW), post menstrual age at first examination and significant perinatal events were noted. The retinopathy details imaged by the RetCam were classified as per ICROP revisited standards.
RESULT
The GA ranged from 36 to 39 weeks and BW from 2.4 to 3.0 kg. Three of them had retinopathy in zone III that regressed spontaneously and one had marked plus with vascular arcades and shunts in zone II that regressed after laser photocoagulation. All of them had fetal distress and multiple systemic comorbidities in the neonatal period.
CONCLUSION
This report makes one aware of the possibility of retinopathy in newborn of older GA and larger BW especially with fetal distress and stormy neonatal course.
目的
报告一系列4例婴儿出现视网膜病变的情况，这些婴儿异常超出了迄今为止文献报道的筛查标准。
方法
在对早产儿视网膜病变进行常规筛查期间，我们在4例婴儿中检测到视网膜病变，这些婴儿的体型和年龄令人惊讶地大于筛查标准。记录了胎龄（GA）、出生体重（BW）、首次检查时的孕龄以及重要的围产期事件。通过RetCam成像的视网膜病变细节根据重新修订的ICROP标准进行分类。
结果
胎龄范围为36至39周，出生体重为2.4至3.0千克。其中3例在Ⅲ区出现视网膜病变，病变自行消退；1例在Ⅱ区有明显的plus病变，伴有血管弓和分流，激光光凝治疗后消退。所有婴儿在新生儿期均有胎儿窘迫和多种全身合并症。
结论
本报告使人们意识到胎龄较大、出生体重较大的新生儿，尤其是伴有胎儿窘迫和新生儿病情凶险时，发生视网膜病变的可能性。
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