Li Jeany Q, Kellner Ulrich, Lorenz Birgit, Stahl Andreas, Krohne Tim U
Universität zu Köln, Zentrum für Augenheilkunde, Medizinische Fakultät und Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
AugenZentrum Siegburg, MVZ Augenärztliches Diagnostik- und Therapiecentrum Siegburg GmbH, Siegburg, Deutschland.
Ophthalmologe. 2021 Dec;118(12):1240-1244. doi: 10.1007/s00347-021-01393-6. Epub 2021 Apr 30.
Due to improvements in neonatal care of premature infants and the development of novel treatment options for retinopathy of prematurity (ROP), the requirements for screening for ROP have changed since publication of the last version of the German ROP screening guideline in 2008. Based on results of recent studies, the guideline has been extensively revised in 2020 and published in an updated version.
This article summarizes the most important changes in the new guideline.
The age limit for screening inclusion was lowered to a gestational age of below 31 weeks for infants without additional risk factors. The minimum duration of oxygen supplementation necessitating screening inclusion in preterm infants was increased to more than 5 days. Treatment for ROP in zone II can now be given at any stage 3 with plus disease, regardless of the number of clock hours affected. Criteria for the frequency and duration have been defined for follow-up examinations after anti-vascular endothelial growth factor (VEGF) treatment. The binding document for these and other new recommendations is the guideline itself.
The guideline recommendations enable a reliable identification of infants at risk for ROP for screening inclusion and a timely detection of advanced disease stages for treatment initiation, thus preventing blindness from ROP.
由于早产儿新生儿护理的改善以及早产儿视网膜病变(ROP)新治疗方案的发展,自2008年德国ROP筛查指南的上一版发布以来,ROP筛查的要求已经发生了变化。基于近期研究结果,该指南于2020年进行了广泛修订并发布了更新版本。
本文总结了新指南中最重要的变化。
对于无其他危险因素的婴儿,筛查纳入的年龄限制降低至孕龄低于31周。早产儿筛查纳入所需的最低吸氧持续时间增加至超过5天。现在,无论受影响的钟点数多少,二区ROP在任何3期加病变阶段均可进行治疗。针对抗血管内皮生长因子(VEGF)治疗后的随访检查,已经定义了频率和持续时间的标准。这些以及其他新建议的关联文件是指南本身。
指南建议能够可靠地识别有ROP风险的婴儿以纳入筛查,并及时检测到疾病的晚期阶段以便开始治疗,从而预防ROP导致的失明。