Yan H X, Li M H, Zhang Z F, Wang L, Wu L, Fan J, Zhou Y, Gou K L, Wang Y S
Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military MedicalUniversity, Xi'an 710032, China.
Zhonghua Yan Ke Za Zhi. 2021 Oct 11;57(10):777-783. doi: 10.3760/cma.j.cn112142-20201217-00823.
To explore the incidence and age distribution of fundus abnormalities in pediatric patients aged 0-3 years in northwest China. A retrospective study of the clinical data of 8808 pediatric patients aged 0-3 years who underwent fundus examination with a wide-filed digital retinal imaging system and an indirect ophthalmoscope in our hospital from January 2008 to December 2019 were performed. There were 5092 males and 3716 females, with a median age of 1 month (range, 3 days to 3 years), a mean gestational age of 34.32 (SD 2.92) weeks (range, 24 to 42 weeks) and a mean birth weight of 2006.92 (SD 709.23) g (range, 490 to 5500 g), from Shaanxi Province (7415 cases, 84.18%), Gansu Province (770 cases, 8.74%), Ningxia Hui Autonomous Region (94 cases, 1.07%), Qinghai Province (53 cases, 0.60%), Xinjiang Uygur Autonomous Region (14 cases, 0.16%) and other neighboring areas (462 cases, 5.25%). The fundus condition of the enrolled pediatric patients was documented to calculate the annual detection rate. The joinpoint regression model was drawn to estimate the annual percent change and average annual percent change. The constituent ratios and age distribution of different types of fundus abnormalities were finally analyzed. Fundus abnormalities were detected in 2 531 cases (28.74%). During the 12 years, the number of pediatric patients undergoing fundus examination each year in our center increased rapidly in the first 7 years, and then kept almost stable, while the number of fundus abnormality cases increased year by year. The positive detection rate showed an overall upward trend with an average annual percent change of +7.2%, and it was +30.09% from 2016 to 2019. Among all the pediatric patients with fundus abnormalities, there were 1 678 cases with developmental diseases (66.30%), 232 cases with hereditary diseases (9.16%), 140 cases with ocular tumor (5.53%), 64 cases with ophthalmic manifestations of systemic diseases (2.53%), 31 cases with ocular trauma (1.23%), 12 cases with infectious diseases or inflammation (0.48%) and 438 cases with other ocular abnormalities (17.31%). The top 5 abnormalities were retinopathy of prematurity (ROP; 1477 cases, 58.36%), gray patchy retinopathy (225 cases, 8.89%), retinal hemorrhage (157 cases, 6.20%), retinoblastoma (137 cases, 5.41%) and familial exudative vitreoretinopathy (77 cases, 3.04%). Fundus abnormalities varied with age. ROP, developmental diseases other than ROP, hereditary diseases, ocular trauma and infectious diseases were mostly detected in pediatric patients at 0-6 months old, while tumors were mostly detected after 1 year old. The detection rate of fundus abnormalities in the Department of Ophthalmology of Xijing Hospital of Air Force Medical University, a tertiary referral center in northwest China, increased notably year by year. The abnormalities were mainly developmental and hereditary lesions as well as of certain age distribution. They occurred with the highest frequency between birth and 6 months of age, in which ROP was in the ascendancy. Meanwhile, the detection rate of other developmental, hereditary and neoplastic disorders increased with age. Therefore, a comprehensive and objective understanding of the fundus disease in infants is essential. .
探讨中国西北地区0至3岁儿童眼底异常的发病率及年龄分布情况。对2008年1月至2019年12月期间在我院接受广域数字化视网膜成像系统及间接检眼镜眼底检查的8808例0至3岁儿童的临床资料进行回顾性研究。其中男性5092例,女性3716例,中位年龄1个月(范围:3天至3岁),平均孕周34.32(标准差2.92)周(范围:24至42周),平均出生体重2006.92(标准差709.23)g(范围:490至5500 g),来自陕西省(7415例,84.18%)、甘肃省(770例,8.74%)、宁夏回族自治区(94例,1.07%)、青海省(53例,0.60%)、新疆维吾尔自治区(14例,0.16%)及其他周边地区(462例,5.25%)。记录纳入儿童患者的眼底情况以计算年检出率。绘制连接点回归模型以估计年变化百分比和平均年变化百分比。最终分析不同类型眼底异常的构成比及年龄分布。共检测出2531例(28.74%)眼底异常。在这12年中,本中心每年接受眼底检查的儿童患者数量在前7年快速增加,之后基本稳定,而眼底异常病例数逐年增加。阳性检出率呈总体上升趋势,平均年变化百分比为+7.2%,2016至2019年为+30.09%。在所有眼底异常的儿童患者中,发育性疾病1678例(66.30%)、遗传性疾病232例(9.16%)、眼肿瘤140例(5.53%)、全身性疾病眼部表现64例(2.53%)、眼外伤31例(1.23%)、感染性疾病或炎症12例(0.48%)、其他眼部异常438例(17.31%)。前5位异常为早产儿视网膜病变(ROP;1477例,58.36%)、灰色斑状视网膜病变(225例,8.89%)、视网膜出血(157例,6.20%)、视网膜母细胞瘤(137例,5.41%)和家族性渗出性玻璃体视网膜病变(77例,3.04%)。眼底异常随年龄而异。ROP、非ROP发育性疾病、遗传性疾病、眼外伤及感染性疾病大多在0至6个月龄儿童中检出,而肿瘤大多在1岁以后检出。中国西北三级转诊中心空军军医大学西京医院眼科的眼底异常检出率逐年显著增加。异常主要为发育性和遗传性病变且有一定年龄分布。出生至6个月龄时发生率最高,其中ROP占主导。同时,其他发育性、遗传性和肿瘤性疾病的检出率随年龄增加。因此,全面客观了解婴儿眼底疾病至关重要。