Chen Yi, Feng Jing, Li Fangting, Yin Hong, Liang Jianhong, Li Xiaoxin
Department of Ophthalmology, People's Hospital, Peking University, and Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China.
Retina. 2015 Aug;35(8):1674-9. doi: 10.1097/IAE.0000000000000512.
To describe the changes in the characteristics of infants treated for severe retinopathy of prematurity (ROP) in a tertiary referral unit in China after screening guidelines were issued in 2004 and to evaluate the effectiveness of the current criteria.
Information on consecutive infants referred to a single eye department for treatment of Stage 3 (Type 1 pretheshold and threshold disease), Stage 4, and Stage 5 ROP between January 2001 and May 2012 was retrieved from medical records.
The mean gestational age was 29.98 ± 2.13 weeks (range 26-34 weeks), and the mean birth weight was 1,414.32 ± 343.18 g (range 742-2,087 g). The proportion of infants with Stage 4 and Stage 5 ROP decreased statistically significantly over time (P = 0.026 and P < 0.001, respectively) after screening guidelines for ROP were issued in 2004. The median postmenstrual age when patients first visited the study hospital was 48.32 weeks (range 30-602 weeks); later presentation was significantly associated with more advanced ROP (P < 0.001). In addition, the postmenstrual age of first presentation showed a significant decrease over time (P < 0.001) after the screening guidelines were issued. The current Chinese screening guidelines cover 99.63% of infants while 9.07% of infants exceeded the U.K. screening criteria and 35.77% of infants exceeded the U.S. criteria.
After the government issued guidelines on ROP screening, the birth weight and gestational age of severe ROP patients remain similar. Big infants got severe ROP as before. But the awareness of ROP increased, the proportion of infants with retinal detachment caused by ROP decreased, and the infants received more timely treatment. The current ROP screening criteria are very effective.
描述2004年发布筛查指南后，中国一家三级转诊单位中接受重度早产儿视网膜病变（ROP）治疗的婴儿特征变化，并评估现行标准的有效性。
从病历中检索2001年1月至2012年5月期间连续转诊至单一眼科治疗3期（1型阈值前期和阈值疾病）、4期和5期ROP的婴儿信息。
平均胎龄为29.98±2.13周（范围26 - 34周），平均出生体重为1414.32±343.18克（范围742 - 2087克）。2004年发布ROP筛查指南后，4期和5期ROP婴儿的比例随时间呈统计学显著下降（分别为P = 0.026和P < 0.001）。患者首次就诊于研究医院时的月经后年龄中位数为48.32周（范围30 - 602周）；就诊时间较晚与更晚期的ROP显著相关（P < 0.001）。此外，筛查指南发布后，首次就诊的月经后年龄随时间呈显著下降（P < 0.001）。现行中国筛查指南涵盖99.63%的婴儿，而9.07%的婴儿超过英国筛查标准，35.77%的婴儿超过美国标准。
政府发布ROP筛查指南后，重度ROP患者的出生体重和胎龄保持相似。大婴儿仍像以前一样患重度ROP。但对ROP的认识提高了，因ROP导致视网膜脱离的婴儿比例下降，且婴儿得到了更及时的治疗。现行ROP筛查标准非常有效。
