Quinn Graham E, Barr Charles, Bremer Don, Fellows Rae, Gong Alice, Hoffman Robert, Repka Michael X, Shepard Jennifer, Siatkowski R Michael, Wade Kelly, Ying Gui-Shuang
Ophthalmology, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Department of Ophthalmology, University of Louisville School of Medicine, Louisville, Kentucky.
Ophthalmology. 2016 Jul;123(7):1595-600. doi: 10.1016/j.ophtha.2016.03.026. Epub 2016 Apr 12.
To compare infant and retinopathy of prematurity (ROP) characteristics from 3 clinical studies conducted over a 27-year period in the United States.
Secondary analysis of results of 3 clinical studies.
Infants with birth weight (BW) <1251 g.
Analysis of data from the Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) and Early Treatment for Retinopathy of Prematurity (ETROP) trials and the primary data from the Telemedicine Approaches for the Evaluation of Acute-Phase Retinopathy of Prematurity (e-ROP) study.
Infant characteristics and onset, severity, and time course of ROP.
Across the 3 studies, mean (standard deviation) BW and mean gestational age (GA) decreased over time from CRYO-ROP (954 g [185 g], 27.9 weeks [2.2 weeks]) to ETROP (907 g [205 g], 27.4 weeks [2.2 weeks]) to e-ROP (864 g [212 g], 27.0 weeks [2.2 weeks]), with an increase in the percentage of infants enrolled weighing <750 g (15.8% CRYO, 24.9% ETROP, 33.4% e-ROP; P<0.0001). The percentage of infants who developed ROP varied only minimally (65.8% CRYO, 68.0% ETROP, 63.7% e-ROP; P = 0.003). Moderately severe ROP (defined as prethreshold or referral warranted) varied (17.8% CRYO, 12.3% ETROP, 19.4% e-ROP; P<0.0001), whereas the time of onset of any ROP did not vary (34.3 weeks CRYO, 34.1 weeks ETROP, 34.8 weeks e-ROP).
The BW and GA of infants enrolled in ROP studies in the United States have decreased over the past 27 years, whereas ROP prevalence and onset of disease are stable.
比较在美国27年间开展的3项临床研究中的婴儿及早产儿视网膜病变(ROP)特征。
对3项临床研究结果进行二次分析。
出生体重(BW)<1251 g的婴儿。
分析早产儿视网膜病变冷冻治疗(CRYO-ROP)和早产儿视网膜病变早期治疗(ETROP)试验的数据,以及早产儿急性期视网膜病变远程医疗评估(e-ROP)研究的原始数据。
婴儿特征以及ROP的发病情况、严重程度和病程。
在这3项研究中,平均(标准差)出生体重和平均胎龄随时间从CRYO-ROP(954 g [185 g],27.9周[2.2周])降至ETROP(907 g [205 g],27.4周[2.2周])再降至e-ROP(864 g [212 g],27.0周[2.2周]),体重<750 g的入组婴儿百分比增加(CRYO为15.8%,ETROP为24.9%,e-ROP为33.4%;P<0.0001)。发生ROP的婴儿百分比仅有极小差异(CRYO为65.8%,ETROP为68.0%,e-ROP为63.7%;P = 0.003)。中度严重ROP(定义为阈值前或需转诊)有所不同(CRYO为17.8%,ETROP为12.3%,e-ROP为19.4%;P<0.0001),而任何ROP的发病时间无差异(CRYO为34.3周,ETROP为34.1周,e-ROP为34.8周)。
在过去27年里,美国ROP研究中入组婴儿的出生体重和胎龄有所下降,而ROP患病率和疾病发病情况保持稳定。