尼泊尔早产儿和足月儿生命早期的屈光状态

Refractive Status in Nepalese Pre-Term and Full-Term Infants Early in Life.

作者信息

Uprety Samir, Morjaria Priya, Shrestha Jyoti B, Shrestha Gauri S, Khanal Safal

机构信息

1College of Optometry, Southwestern University, Cebu City, Philippines 2Faculty of Infectious Tropical Diseases, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom 3BP Koirala Lions Center for Ophthalmic Studies, Institute of Medicine, Kathmandu, Nepal 4School of Optometry and Vision Science, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand *Contributed equally to this work †

出版信息

Optom Vis Sci. 2017 Oct;94(10):957-964. doi: 10.1097/OPX.0000000000001118.

DOI:10.1097/OPX.0000000000001118

PMID:28858003

Abstract

SIGNIFICANCE

This study suggests that pre-term infants, even without retinopathy of prematurity, are at risk for abnormal refractive development and informs the need for close monitoring of refractive error in such infants, regardless of their retinopathy of prematurity status.

PURPOSE

The present study aims to investigate the refractive error trend in Nepalese pre-term infants without retinopathy of prematurity (ROP) in the first 6 months of life and explore the association of refractive error with birth weight (BW) and gestational age (GA).

METHODS

Thirty-six pre-term infants without ROP and 40 full-term infants underwent cycloplegic retinoscopy at birth, term (for pre-term only), 3 months, and 6 months chronologically. Refractive status was classified into emmetropia (mean spherical equivalent refraction [SER] 0 to +3.00D), myopia (SER < 0.00D), and significant hyperopia (SER > +3.00D). Refractive parameters at various age points were compared between the pre-term and full-term infants using general linear model repeated measures ANOVA.

RESULTS

At birth, the SER in the pre-term infants was +0.84 ± 1.72D; however, there was a shift toward myopia at 6 months of age (SER = -0.33 ± 1.95D). There was a significant difference in SER, astigmatism, and anisometropia between pre-term and full-term infants by 6 months of age (P < .01). Astigmatism and anisometropia showed an increasing trend with age in pre-term infants (P < .05 at 6 months) in contrast to a decreasing trend in full-term infants (P < 0.05 at 3 and 6 months). In pre-term infants, there was a statistically significant positive relationship between GA and SER (β = 0.32, R = 17.6%, P < .05) but a negative relationship between BW and astigmatism (β = -1.25, R = 20.6%, P < .01).

CONCLUSIONS

Pre-term infants who do not develop ROP show a trend toward increasing myopia and demonstrate greater astigmatism and anisometropia than full-term infants in their first 6 months of life.

摘要

意义

本研究表明，即使没有早产儿视网膜病变，早产儿也存在屈光发育异常的风险，并提示无论其早产儿视网膜病变状况如何，都需要密切监测此类婴儿的屈光不正情况。

目的

本研究旨在调查尼泊尔无早产儿视网膜病变（ROP）的早产儿在出生后前6个月的屈光不正趋势，并探讨屈光不正与出生体重（BW）和胎龄（GA）之间的关联。

方法

36例无ROP的早产儿和40例足月儿在出生时、足月时（仅适用于早产儿）、3个月和6个月时按时间顺序接受了睫状肌麻痹验光。屈光状态分为正视（平均球镜等效屈光度[SER]为0至+3.00D）、近视（SER < 0.00D）和显著远视（SER > +3.00D）。使用一般线性模型重复测量方差分析比较早产儿和足月儿在不同年龄点的屈光参数。

结果

出生时，早产儿的SER为+0.84±1.72D；然而，在6个月大时出现向近视的转变（SER = -0.33±1.95D）。到6个月大时，早产儿和足月儿在SER、散光和屈光参差方面存在显著差异（P <.01）。与足月儿（3个月和6个月时P < 0.05）呈下降趋势相反，早产儿的散光和屈光参差随年龄呈上升趋势（6个月时P <.05）。在早产儿中，GA与SER之间存在统计学上显著的正相关关系（β = 0.32，R = 17.6%，P <.05），但BW与散光之间存在负相关关系（β = -1.25，R = 20.6%，P <.01）。