Dikopf Mark S, Machen Lindsay A, Hallak Joelle A, Chau Felix Y, Kassem Iris S
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois; Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin.
J AAPOS. 2019 Aug;23(4):211.e1-211.e6. doi: 10.1016/j.jaapos.2019.03.006. Epub 2019 Jun 20.
To evaluate the relationship between zone of retinal vascularization and refractive error in premature infants without retinopathy of prematurity (ROP) or with spontaneously regressed ROP.
The medical records of neonates screened for ROP between 2009 and 2015 at a tertiary academic center were reviewed retrospectively. Cases included untreated eyes with spontaneously regressed ROP; premature eyes without a diagnosis of ROP were control subjects. Primary outcomes were zone of retinal vascularization and refractive error, determined by cycloplegic retinoscopy (CR).
Of 378 eyes evaluated, 184 had ROP, 24 of which underwent treatment and were excluded. Mean corrected age at first CR was 7.5 months. Seventeen eyes without ROP were myopic at first CR (8.8%), compared to 35 eyes with regressed ROP (21.9%). No untreated eyes had halted vasculature in zone I; notably, 44% of spontaneously regressed zone II eyes were myopic. Irrespective of ROP status, CR significantly differed by zone of vascularization (P < 0.001), with more myopia occurring with posterior halting of vascularization. For all eyes, CR significantly differed between complete vascularization versus zone II (P < 0.0001) and zone III versus zone II (P = 0.001); zone III versus complete vascularization did not statistically differ (P = 0.15). This relationship held true for untreated, spontaneously regressed ROP eyes (P < 0.01, P = 0.01, P = 0.8343).
More myopic refraction occurred in neonates screened for ROP with posterior halting of vascularization. Patients with halted vascular growth in zone II should be closely monitored for myopia and refractive amblyopia.
评估无早产儿视网膜病变（ROP）或ROP自然消退的早产儿视网膜血管化区域与屈光不正之间的关系。
回顾性分析2009年至2015年在一家三级学术中心接受ROP筛查的新生儿病历。病例包括ROP自然消退的未治疗眼；未诊断出ROP的早产儿眼作为对照。主要结局指标为视网膜血管化区域和屈光不正，通过睫状肌麻痹验光（CR）确定。
在评估的378只眼中，184只患有ROP，其中24只接受了治疗并被排除。首次CR时的平均矫正年龄为7.5个月。17只无ROP的眼在首次CR时为近视（8.8%），相比之下，35只ROP消退的眼为近视（21.9%）。没有未治疗的眼在I区出现血管停止；值得注意的是，44%的自然消退的II区眼为近视。无论ROP状态如何，CR在血管化区域之间有显著差异（P<0.001），血管化后停止时近视发生率更高。对于所有眼，完全血管化与II区之间的CR有显著差异（P<0.0001），III区与II区之间的CR有显著差异（P=0.001）；III区与完全血管化之间无统计学差异（P=0.15）。这种关系在未治疗的、ROP自然消退的眼中也成立（P<0.01，P=0.01，P=0.8343）。
在接受ROP筛查且血管化后停止的新生儿中，近视性屈光不正更为常见。II区血管生长停止的患者应密切监测近视和屈光性弱视。
