Solans Pérez de Larraya Ana M, Ortega Molina José M, Fernández José Uberos, Escudero Gómez Júlia, Salgado Miranda Andrés D, Chaves Samaniego Maria J, García Serrano José L
1 Department of Ophthalmology, San Cecilio University Hospital, Granada, Spain.
2 Department of Paediatrics, San Cecilio University Hospital, Granada, Spain.
Eur J Ophthalmol. 2018 Jul;28(4):441-445. doi: 10.1177/1120672118761328. Epub 2018 Mar 27.
To analyse the speed of temporal retinal vascularisation in preterm infants included in the screening programme for retinopathy of prematurity.
A total of 185 premature infants were studied retrospectively between 2000 and 2017 in San Cecilio University Hospital of Granada, Spain. The method of binocular indirect ophthalmoscopy with indentation was used for the examination. The horizontal disc diameter was used as a unit of length. Speed of temporal retinal vascularisation (disc diameter/week) was calculated as the ratio between the extent of temporal retinal vascularisation (disc diameter) and the time in weeks.
The weekly temporal retinal vascularisation (0-1.25 disc diameter/week, confidence interval) was significantly higher in no retinopathy of prematurity (0.73 ± 0.22 disc diameter/week) than in stage 1 retinopathy of prematurity (0.58 ± 0.22 disc diameter/week). It was also higher in stage 1 than in stages 2 (0.46 ± 0.14 disc diameter/week) and 3 of retinopathy of prematurity (0.36 ± 0.18 disc diameter/week). The rate of temporal retinal vascularisation (disc diameter/week) decreases when retinopathy of prematurity stage increases. The area under the receiver operating characteristic curve was 0.85 (95% confidence interval: 0.79-0.91) for retinopathy of prematurity requiring treatment versus not requiring treatment. The best discriminative cut-off point was a speed of retinal vascularisation <0.5 disc diameter/week, with a sensitivity and a specificity of 84.8% and 77%, respectively.
The rate of temporal retinal vascularisation is a quantifiable observation that can help to alert a clinician that treatment of retinopathy of prematurity may be required. However, before becoming a new standard of care for treatment, it requires careful documentation, with agreement between several ophthalmologists.
分析纳入早产儿视网膜病变筛查项目的早产儿视网膜颞侧血管化速度。
2000年至2017年期间，在西班牙格拉纳达圣塞西利奥大学医院对185例早产儿进行了回顾性研究。采用带压陷的双目间接检眼镜检查法进行检查。以水平视盘直径作为长度单位。视网膜颞侧血管化速度（视盘直径/周）通过视网膜颞侧血管化程度（视盘直径）与周数之比计算得出。
无早产儿视网膜病变时，每周视网膜颞侧血管化程度（0 - 1.25视盘直径/周，置信区间）显著高于1期早产儿视网膜病变（0.73±0.22视盘直径/周）。1期也高于2期（0.46±0.14视盘直径/周）和3期早产儿视网膜病变（0.36±0.18视盘直径/周）。早产儿视网膜病变分期增加时，视网膜颞侧血管化速度（视盘直径/周）降低。对于需要治疗与不需要治疗的早产儿视网膜病变，受试者操作特征曲线下面积为0.85（95%置信区间：0.79 - 0.91）。最佳鉴别临界点为视网膜血管化速度<0.5视盘直径/周，敏感性和特异性分别为84.8%和77%。
视网膜颞侧血管化速度是一项可量化的观察指标，有助于提醒临床医生可能需要对早产儿视网膜病变进行治疗。然而，在成为新的治疗标准之前，它需要仔细记录，并得到多位眼科医生的认可。
