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土耳其一家转诊中心出生体重超过1500克婴儿的重度早产儿视网膜病变特征

Characteristics of Severe Retinopathy of Prematurity in Infants with Birth Weight above 1500 Grams at a Referral Center in Turkey.

作者信息

Gunay Murat, Celik Gokhan, Tuten Abdulhamit, Karatekin Guner, Bardak Handan, Ovali Fahri

机构信息

Department of Ophthalmology, Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey.

Department of Neonatology, Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital, Istanbul, Turkey.

出版信息

PLoS One. 2016 Aug 22;11(8):e0161692. doi: 10.1371/journal.pone.0161692. eCollection 2016.

Abstract

PURPOSE

To demonstrate the clinical characteristics and treatment outcomes of severe retinopathy of prematurity (ROP) in preterm infants with birth weight (BW) above 1500 g in Turkey.

METHODS

A retrospective review of 5920 ROP records was performed in Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital. The records were obtained from ROP treatment center of the same institute between 2011 and 2016. The data comprised the demographic and clinical characteristics including, gestational age, BW, systemic risk factors, zone and stage of ROP, ROP type, treatment modality, treatment outcomes and inborn/outborn status of the babies.

RESULTS

A total of 36 infants (71 eyes) with severe ROP and BW> 1500 g were retrieved. There were 30 infants (83.3%) with type 1 ROP and 6 infants (16.7%) with aggressive posterior ROP (APROP). 3 infants (8.3%) were born at our hospital whereas 33 (91.7%) were referred from outer private neonatal intensive care unit (NICU) centers. Zone I APROP was detected during the initial screening. 21 infants (58.3%) underwent laser treatment while 15 (41.7%) received intravitreal bevacizumab (IVB) injections. No unfavorable structural outcome was observed following either treatment modality.

CONCLUSION

Severe ROP may occur in heavier preterm infants. Laser treatment and IVB injections were useful in selected cases. Presence of APROP at first examination suggests an earlier screening in heavier babies. Standardization of private NICU centers as well as establishing a national ROP protocol is necessary in Turkey.

摘要

目的

阐述土耳其出生体重(BW)超过1500g的早产儿重度早产儿视网膜病变(ROP)的临床特征及治疗效果。

方法

对泽伊内普·卡米尔妇产儿童医院5920份ROP记录进行回顾性研究。这些记录取自同一机构的ROP治疗中心2011年至2016年期间的数据。数据包括人口统计学和临床特征,如胎龄、出生体重、全身危险因素、ROP的区域和阶段、ROP类型、治疗方式、治疗效果以及婴儿的出生地点(本院出生/外院转入)。

结果

共检索到36例(71只眼)出生体重>1500g的重度ROP婴儿。其中1型ROP 30例(83.3%),侵袭性后部ROP(APROP)6例(16.7%)。3例(8.3%)在本院出生,33例(91.7%)从外部私立新生儿重症监护病房(NICU)转诊而来。在初次筛查时发现了I区APROP。21例(58.3%)接受了激光治疗,15例(41.7%)接受了玻璃体内注射贝伐单抗(IVB)。两种治疗方式均未观察到不良结构结局。

结论

较重的早产儿也可能发生重度ROP。激光治疗和IVB注射在部分病例中有效。初次检查时发现APROP提示对较重婴儿应尽早进行筛查。土耳其有必要规范私立NICU中心并制定全国性ROP诊疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/447b/4993354/b836846b7b5a/pone.0161692.g001.jpg

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