Fajolu I B, Rotimi-Samuel A, Aribaba O T, Musa K O, Akinsola F B, Ezeaka V C, Onakoya A O
Department of Paediatrics, College of Medicine, University of Lagos , Nigeria.
Paediatr Int Child Health. 2015;35(4):324-8. doi: 10.1080/20469047.2015.1109277.
Screening and early treatment of retinopathy of prematurity (ROP) is important to reduce visual impairment in at risk infants.
To determine the frequency and risk factors associated with ROP in preterm infants in Lagos University Teaching Hospital.
This was a prospective cohort study of preterm infants with gestational age (GA) less than 32 weeks and birthweight 1500 g or less conducted from November 2011 to May 2014. The infants' eyes were examined using an indirect ophthalmoscope at 4-6 weeks of life or at 34 weeks post-conceptual age. Examinations were repeated weekly until regression or progression to a high risk pre-threshold disease. Staging was according to the revised International Classification for ROP and treatment criteria were as defined by the Early Treatment for ROP study. The GA, birth weight (BW), use of oxygen, presence of respiratory distress syndrome and other risk factors were recorded and tested for significance.
Twelve (15%) of the 80 infants examined had any ROP and six (7.5%) had treatable ROP. The mean (SD) GA and BW for infants with ROP were both lower than for those without ROP; 28.2 (1.7) weeks vs 29.1 (1.6) weeks and 1124 (212) g vs 1251 (274) g for GA and BW, respectively. Risk factors such as supplemental oxygen, sepsis, respiratory distress and anaemia were not significantly associated with ROP.
The frequency of ROP and treatable ROP was high; it is therefore recommended that routine care of preterm infants should include screening for ROP and that affordable treatment facilities should be provided in public hospitals.
对早产儿视网膜病变(ROP)进行筛查和早期治疗对于降低高危婴儿的视力损害至关重要。
确定拉各斯大学教学医院早产儿中ROP的发生率及相关危险因素。
这是一项前瞻性队列研究,研究对象为2011年11月至2014年5月期间出生的孕周(GA)小于32周、出生体重1500g及以下的早产儿。在婴儿出生后4 - 6周或孕龄34周时,使用间接检眼镜对其眼睛进行检查。每周重复检查,直至病情消退或进展为高风险的阈值前疾病。分期依据修订后的ROP国际分类标准,治疗标准按照ROP早期治疗研究的定义执行。记录GA、出生体重(BW)、氧气使用情况、呼吸窘迫综合征的存在情况及其他危险因素,并进行显著性检验。
在接受检查的80名婴儿中,12名(15%)患有任何ROP,其中6名(7.5%)患有可治疗的ROP。患有ROP的婴儿的平均(标准差)GA和BW均低于未患ROP的婴儿;GA分别为28.2(1.7)周和29.1(1.6)周,BW分别为1124(212)g和1251(274)g。补充氧气、败血症、呼吸窘迫和贫血等危险因素与ROP无显著相关性。
ROP及可治疗的ROP发生率较高;因此建议对早产儿的常规护理应包括ROP筛查,并且公立医院应提供价格可承受的治疗设施。