Liu Tianyu, Ying Gui-Shuang, Pan Wei, Smith Eli, Baumritter Agnieshka, Quinn Graham E
Division of Ophthalmology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Ophthalmol Retina. 2019 Mar;3(3):278-284. doi: 10.1016/j.oret.2018.10.003. Epub 2018 Oct 9.
To measure the location of the retinopathy of prematurity (ROP) border in a sample of premature infants developed ROP and to determine the location for predicting subsequent development of referral-warranted ROP (defined as stage 3 ROP, zone I ROP, or plus disease) or treated ROP.
Secondary analysis of data from an observational cohort study, the Telemedicine Approaches to Evaluating Acute-Phase Retinopathy of Prematurity study.
Infants with birth weight (BW) of less than 1251 g with at least 1 examination and imaging session at 34 weeks postmenstrual age (PMA) or younger with ROP not meeting referral-warranted ROP and at least 1 subsequent examination at 36 weeks PMA or older.
The 5-image set from the first imaging session for each eligible eye was mosaicked, and measurements of the ROP border were made using Image J. Measurements were compared among 3 groups of eyes with ROP: (1) those that never developed referral-warranted ROP or received treatment, (2) those that developed referral-warranted ROP but did not receive treatment, and (3) those that received treatment.
Referral-warranted ROP and treated ROP.
Three hundred seventeen eyes from 217 infants with mean BW of 755 g, mean gestational age (GA) of 25 weeks, and mean PMA of 33 weeks at first examination met study criteria. Of 211 eyes (66.6%) with sufficient-quality images for grading, 147 (69.7%) did not develop referral-warranted ROP or receive treatment, 36 (17.1%) developed referral-warranted ROP not requiring treatment, and 28 (13.3%) received treatment for ROP. Among all eyes, the disc-to-ROP border distance followed a consistent pattern, with nasal less than inferior less than superior less than temporal. In multivariate analysis adjusted by BW and GA, nasal ROP border distance was a significant predictor of the subsequent development of ROP that was treated (odds ratio, 0.86 for every 10-pixel increase in distance; P = 0.002).
Retinopathy of prematurity is located asymmetrically around the optic disc and is closest to the optic disc nasally. Location of ROP nasally at first imaging is a significant predictor for subsequent development of ROP that was treated.
测量患有早产儿视网膜病变（ROP）的早产儿样本中ROP边界的位置，并确定用于预测后续发生需转诊的ROP（定义为3期ROP、I区ROP或附加病变）或接受治疗的ROP的位置。
对一项观察性队列研究——评估早产儿急性期视网膜病变的远程医疗方法研究——的数据进行二次分析。
出生体重（BW）小于1251g、在孕龄（PMA）34周或更小时至少有1次检查和影像学检查且ROP未达到需转诊标准、在PMA 36周或更大时至少有1次后续检查的婴儿。
对每只符合条件眼睛的首次影像学检查的5幅图像进行拼接，并使用Image J测量ROP边界。在3组患有ROP的眼睛中比较测量结果：（1）从未发生需转诊的ROP或接受治疗的眼睛；（2）发生需转诊的ROP但未接受治疗的眼睛；（3）接受治疗的眼睛。
需转诊的ROP和接受治疗的ROP。
217名婴儿的317只眼睛符合研究标准，首次检查时平均BW为755g，平均孕龄（GA）为25周，平均PMA为33周。在211只（66.6%）有足够质量图像用于分级的眼睛中，147只（69.7%）未发生需转诊的ROP或接受治疗，36只（17.1%）发生需转诊的ROP但无需治疗，28只（13.3%）接受了ROP治疗。在所有眼睛中，视盘到ROP边界的距离遵循一致模式，鼻侧小于下侧小于上侧小于颞侧。在根据BW和GA进行调整的多变量分析中，鼻侧ROP边界距离是后续接受治疗的ROP发生的显著预测因素（距离每增加10像素，比值比为0.86；P = 0.002）。
早产儿视网膜病变在视盘周围呈不对称分布，且在鼻侧最靠近视盘。首次影像学检查时ROP位于鼻侧是后续接受治疗的ROP发生的显著预测因素。
