Neffendorf James E, Mota P Michael, Xue Kanmin, Hildebrand G Darius
Royal Berkshire Hospital, Reading and King Edward VII Hospital, Windsor - UK.
Eur J Ophthalmol. 2015 May-Jun;25(3):249-53. doi: 10.5301/ejo.5000540. Epub 2014 Nov 14.
Retinopathy of prematurity (ROP) is a leading cause of visual loss in infancy that is largely preventable with careful screening. We report the safety and efficacy of the use of phenylephrine 2.5% and cyclopentolate 0.5% eyedrops instilled 3 times 5 minutes apart in ROP screening.
A total of 1246 ROP screening eye examinations were carried out by the same pediatric ophthalmologist between February 2011 and May 2013. Outcome measures were successful mydriasis (defined as achieving a full screening examination) and any intraprocedural systemic complications (defined as any respiratory, cardiac, or other clinical deterioration severe enough to result in screening abandonment).
Of 1246 eyes, 1234 (98.8%) achieved successful dilation to enable complete screening. A fourth application was successful in the remaining 1.2%. No respiratory or cardiac arrest or any other intraprocedural event requiring cessation of screening was encountered during any of the examinations. No retinal bleeding or other intraocular complication occurred.
This is the largest cohort studying the effectiveness and safety of a mydriatic regimen for ROP screening. We have found the combination of phenylephrine 2.5% with cyclopentolate 0.5% to be efficacious and well-tolerated. The absence of any severe intraprocedural complications may be related to reduced indentation time and stress in the infant facilitated by effective pupil dilation.
早产儿视网膜病变（ROP）是婴儿期视力丧失的主要原因，通过仔细筛查在很大程度上是可以预防的。我们报告了在ROP筛查中使用2.5%去氧肾上腺素和0.5%环喷托酯滴眼液，每隔5分钟滴注3次的安全性和有效性。
2011年2月至2013年5月期间，同一位小儿眼科医生共进行了1246次ROP筛查眼部检查。观察指标为散瞳成功（定义为能够完成全面筛查检查）和任何术中全身并发症（定义为任何严重到足以导致筛查放弃的呼吸、心脏或其他临床恶化）。
1246只眼中，1234只（98.8%）散瞳成功，得以完成全面筛查。在其余1.2%的眼中，第四次滴注成功。在任何一次检查中，均未遇到呼吸或心脏骤停或任何其他需要停止筛查的术中事件。未发生视网膜出血或其他眼内并发症。
这是研究ROP筛查散瞳方案有效性和安全性的最大队列研究。我们发现2.5%去氧肾上腺素与0.5%环喷托酯联合使用有效且耐受性良好。未出现任何严重术中并发症可能与有效散瞳使婴儿的压陷时间和压力减少有关。
