Leiden University Medical Center, Leiden, Netherlands.
Maxima Medical Center, Veldhoven, Netherlands.
Acta Ophthalmol. 2021 Feb;99(1):97-103. doi: 10.1111/aos.14501. Epub 2020 Jul 23.
Compare patients treated for Retinopathy of Prematurity (ROP) in two consecutive periods.
Retrospective inventory of anonymized neonatal and ophthalmological data of all patients treated for ROP from 2010 to 2017 in the Netherlands, subdivided in period (P)1: 1-1-2010 to 31-3-2013 and P2: 1-4-2013 to 31-12-2016. Treatment characteristics, adherence to early treatment for ROP (ETROP) criteria, outcome of treatment and changes in neonatal parameters and policy of care were compared.
Overall 196 infants were included, 57 infants (113 eyes) in P1 and 139 (275 eyes) in P2, indicating a 2.1-fold increase in ROP treatment. No differences were found in mean gestational age (GA) (25.9 ± 1.7 versus 26.0 ± 1.7 weeks, p = 0.711), mean birth weight (791 ± 311 versus 764 ± 204 grams, p = 0.967) and other neonatal risk factors for ROP. In P2, the number of premature infants born <25 weeks increased by factor 1.23 and higher oxygen saturation levels were aimed at in most centres. At treatment decision, 59.6% (P1) versus 83.5% (P2) (p = 0.263) infants were classified as Type 1 ROP (ETROP classification). Infants were treated with laser photocoagulation (98 versus 96%) and intravitreal bevacizumab (2 versus 4%). Retreatment was necessary in 10 versus 21 (p = 0.160). Retinal detachment developed in 6 versus 13 infants (p = 0.791) of which 2 versus 6 bilateral (p = 0.599).
In period 2, the number of infants treated according to the ETROP criteria (Type 1) increased, the number of ROP treatments, retinal detachments and retreatments doubled and the absolute number of retinal detachments increased. Neonatal data did not provide a decisive explanation, although changes in neonatal policy were reported.
比较连续两个时期接受早产儿视网膜病变（ROP）治疗的患者。
对荷兰 2010 年至 2017 年间所有接受 ROP 治疗的新生儿和眼科数据进行回顾性库存分析，分为两个时期（P）1：1-1-2010 至 31-3-2013 和 P2：1-4-2013 至 31-12-2016。比较治疗特征、是否符合早期 ROP 治疗（ETROP）标准、治疗结果以及新生儿参数和护理政策的变化。
共纳入 196 名婴儿，P1 组 57 名婴儿（113 只眼），P2 组 139 名婴儿（275 只眼），ROP 治疗增加了 2.1 倍。两组间平均胎龄（GA）（25.9±1.7 与 26.0±1.7 周，p=0.711）、平均出生体重（791±311 与 764±204 克，p=0.967）和其他 ROP 新生儿危险因素无差异。P2 中，出生时胎龄<25 周的早产儿数量增加了 1.23 倍，大多数中心的目标是更高的氧饱和度水平。在治疗决策时，59.6%（P1）与 83.5%（P2）（p=0.263）的婴儿被归类为 1 型 ROP（ETROP 分类）。婴儿接受激光光凝（98%与 96%）和玻璃体内贝伐单抗（2%与 4%）治疗。10 名婴儿（10%）与 21 名婴儿（21%）需要再次治疗（p=0.160）。6 名婴儿（6%）与 13 名婴儿（13%）发生视网膜脱离（p=0.791），其中 2 名婴儿（2%）与 6 名婴儿（6%）为双侧（p=0.599）。
在第二阶段，根据 ETROP 标准（1 型）接受治疗的婴儿数量增加，ROP 治疗、视网膜脱离和再次治疗的数量增加了一倍，视网膜脱离的绝对数量增加。尽管报道了新生儿政策的变化，但新生儿数据并没有提供决定性的解释。
