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早产儿视网膜病变:哥斯达黎加的筛查与治疗

Retinopathy of prematurity: screening and treatment in Costa Rica.

作者信息

Tabarez-Carvajal Ana Catalina, Montes-Cantillo Milagro, Unkrich Kelly H, Trivedi Rupal H, Peterseim Mae Millicent Winfrey

机构信息

National Children's Hospital of Dr Carlos Sáenz Herrera, San Jose, Costa Rica.

Storm Eye Institute/Medical University of South Carolina Department of Ophthalmology, Charleston, South Carolina, USA.

出版信息

Br J Ophthalmol. 2017 Dec;101(12):1709-1713. doi: 10.1136/bjophthalmol-2016-310005. Epub 2017 Apr 12.

Abstract

AIM

To determine the recent demographic data, risk factors and results of retinopathy of prematurity (ROP) screening and treatment in Costa Rica.

METHODS

The medical records of all preterm infants meeting ROP screening criteria (≤34 weeks' gestational age (GA) or birth weight (BW) ≤1750g, and those determined at risk by neonatologists) in the national healthcare system, Costa Rica, January 2010-December 2014, were retrospectively reviewed. The numbers and percentages of infants with ROP, risk factors, percentage of patients treated and treatment outcomes were determined. Comparison is made with screening criteria and literature reports of ROP incidence in other countries.

RESULTS

The study population included 3018 preterm infants. Overall, 585 patients (585/3018, 19.4%) were found to have ROP. Of these, 15.4% (90 patients) required laser treatment, and 53% of those requiring treatment had BW <1000g. Five babies requiring treatment were ≥32 weeks' GA but with BW ≤1750g. Aggressive posterior disease was found in nine patients, and two infants of those screened (2/3018, 0.07%) suffered severe visual impairment during the 5-year study period.

CONCLUSION

We provide comprehensive data of ROP care in Costa Rica allowing assessment and comparison of screening criteria and protocol.

摘要

目的

确定哥斯达黎加早产儿视网膜病变(ROP)筛查及治疗的近期人口统计学数据、危险因素和结果。

方法

回顾性分析2010年1月至2014年12月在哥斯达黎加国家医疗系统中所有符合ROP筛查标准(胎龄(GA)≤34周或出生体重(BW)≤1750g,以及新生儿科医生判定有风险的婴儿)的早产儿的病历。确定患有ROP的婴儿数量及百分比、危险因素、接受治疗的患者百分比及治疗结果。并与其他国家的ROP筛查标准和发病率文献报道进行比较。

结果

研究人群包括3018名早产儿。总体而言,585名患者(585/3018,19.4%)被发现患有ROP。其中,15.4%(90名患者)需要进行激光治疗,且需要治疗的患者中有53%的BW<1000g。5名需要治疗的婴儿GA≥32周但BW≤1750g。9名患者发现有侵袭性后部病变,在5年研究期间,2名接受筛查的婴儿(2/3018,0.07%)出现严重视力损害。

结论

我们提供了哥斯达黎加ROP治疗的综合数据,以便对筛查标准和方案进行评估和比较。

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