Paulino Jose Antonio Tan, Santiago Alvina Pauline Dy, Santiago Darby Espiritu
Department of Ophthalmology and Visual Sciences, Philippine General Hospital, Manila, Metro Manila, Philippines.
Philippine Eye Research Institute, Manila, Philippines.
BMJ Open Ophthalmol. 2020 Oct 20;5(1):e000448. doi: 10.1136/bmjophth-2020-000448. eCollection 2020.
Compare the detection rates of the 2013 Philippine Academy of Ophthalmology (PAO) guidelines for retinopathy of prematurity (ROP) screening and the 2005 PAO-Philippine Pediatric Society guidelines in identifying infants who develop ROP in the 5-year study period in the Philippine General Hospital (PGH). Secondary objectives include determination of ROP prevalence; correlation of gestational age (GA), birth weight (BW) and other risk factors to ROP; and identification of the most common intervention.
Retrospective cross-sectional study of ROP records between 1 December 2013 and 30 November 2018 from the Medical Retina Service of the Department of Ophthalmology and Visual Sciences of the institution was studied. Variables with p value <0.05 were considered significant. STATA V.14 was used for all analysis.
Only 851 of 898 infants screened for ROP were included in the study. Of these 698 would have been screened based on 2005 guidelines. All 118 infants with ROP were identified by both guidelines. Detection rate was higher using the 2005 than the 2013 guidelines (16.9% vs 13.3%, p value=0.0496). ROP prevalence was 9.7%. Among those with ROP, 70% have at least one identified risk factor, topped by sepsis, pneumonia, hyaline membrane disease, blood transfusion and oxygen supplementation. Only 8% required intervention consisting of laser, anti-vascular endothelial growth factor injection, surgery or in combination.
In PGH, no infants with ROP were missed using the 2005 recommendations. There was no added benefit of increasing threshold for BW and GA as recommended by the 2013 PAO guidelines. Screening guidelines should, however, be tailored to institutional needs, requirements and experience.
比较2013年菲律宾眼科学会（PAO）早产儿视网膜病变（ROP）筛查指南和2005年PAO - 菲律宾儿科学会指南在菲律宾总医院（PGH）5年研究期间识别发生ROP的婴儿的检出率。次要目标包括确定ROP患病率；胎龄（GA）、出生体重（BW）和其他危险因素与ROP的相关性；以及确定最常见的干预措施。
对该机构眼科与视觉科学部医学视网膜服务中心2013年12月1日至2018年11月30日期间的ROP记录进行回顾性横断面研究。p值<0.05的变量被认为具有统计学意义。所有分析均使用STATA V.14软件。
898名接受ROP筛查的婴儿中，只有851名被纳入研究。根据2005年指南，其中698名婴儿本应接受筛查。两种指南均识别出了所有118名患有ROP的婴儿。2005年指南的检出率高于2013年指南（16.9%对13.3%，p值 = 0.0496）。ROP患病率为9.7%。在患有ROP的婴儿中，70%至少有一项已确定的危险因素，其中以败血症、肺炎、透明膜病、输血和吸氧最为常见。只有8%的婴儿需要进行包括激光、抗血管内皮生长因子注射、手术或联合治疗在内的干预。
在PGH，使用2005年建议未遗漏任何患有ROP的婴儿。按照2013年PAO指南提高BW和GA的筛查阈值并无额外益处。然而，筛查指南应根据机构的需求、要求和经验进行调整。
