J Pediatr Ophthalmol Strabismus. 2021 Jul-Aug;58(4):240-245. doi: 10.3928/01913913-20210122-02. Epub 2021 Jul 1.
To estimate the prevalence of retinopathy of prematurity (ROP) among high-risk neonates and to illuminate the benefits of early treatment in type 2 ROP (zone II, stage 3 without plus) and ROP milder than type 1 with pre-plus disease (zone III, stage 3).
This retrospective cross-sectional study was conducted among 307 high-risk neonates (614 eyes) with a gestational age of 32 weeks or younger at birth and a birth weight of 1,500 g or less, from 2011 to 2016. Treatment was initiated for neonates with low-risk type 2 ROP and ROP milder than type 1 with pre-plus disease, whenever retinopathy was evident for 3 clock hours with or without vitreous hemorrhage. Post-treatment progression was recorded.
The prevalence of ROP in the current study was 33.71%. Two hundred seven eyes had ROP; 47.34% had mild retinopathy that did not require treatment, and 52.66% received laser treatment, including the early treated group. Of the 207 eyes with ROP, 46.86% had low-risk type 2 ROP disease and ROP milder than type 1 with pre-plus disease, and underwent photocoagulation therapy. After treatment, 15.38% and 10.71% eyes were stable, 84.62% and 88.10% eyes had regressed retinopathy, and 0% and 1.19% progressed in both groups, respectively.
Early treatment of type 2 ROP and ROP milder than type 1 with pre-plus disease in certain cases significantly decreased the rate of progression to more advanced stages and resulted in good clinical outcomes. .
估计早产儿视网膜病变(ROP)在高危新生儿中的患病率,并阐明在 2 型 ROP(无 plus 的 II 区 3 期)和ROP 轻度但有前 plus 病变的 1 型(III 区 3 期)中早期治疗的益处。
这是一项回顾性的病例对照研究,纳入了 2011 年至 2016 年期间出生时胎龄 32 周或更小、出生体重 1500g 或更低的 307 例高危新生儿(614 只眼)。对于低危 2 型 ROP 和ROP 轻度但有前 plus 病变的新生儿,只要出现 3 个时钟小时的视网膜病变且伴或不伴玻璃体积血,即开始治疗。记录治疗后的进展情况。
本研究ROP 的患病率为 33.71%。207 只眼患有 ROP;47.34%的患儿为轻度视网膜病变,无需治疗,52.66%的患儿接受了激光治疗,包括早期治疗组。在 207 只患有 ROP 的眼中,46.86%为低危 2 型 ROP 病变和ROP 轻度但有前 plus 病变,行光凝治疗。治疗后,15.38%和 10.71%的眼稳定,84.62%和 88.10%的眼病变消退,两组分别有 0%和 1.19%的眼进展。
在某些情况下,早期治疗 2 型 ROP 和ROP 轻度但有前 plus 病变可显著降低进展至更晚期的发生率,并获得良好的临床结局。