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荷兰早产儿视网膜病变筛查的全国性调查。

Nationwide inventory on retinopathy of prematurity screening in the Netherlands.

机构信息

Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands

Neonatology, Wilhelmina Children's Hospital-University Medical Center, Utrecht, The Netherlands.

出版信息

Br J Ophthalmol. 2023 May;107(5):712-716. doi: 10.1136/bjophthalmol-2021-319929. Epub 2021 Dec 10.

Abstract

PURPOSE

Provide up-to-date insight in incidence of retinopathy of prematurity (ROP), logistics of screening and treatment in the Netherlands and influence of the new national ROP guideline in which more stringent screening criteria were implemented and the early treatment for ROP criteria (ETROP) were emphasised.

METHODS

Multicentre prospective nationwide study including all preterm infants, born in the Netherlands in 2017, and considered eligible for ROP screening. Anonymised data from ophthalmologists and paediatricians were merged. Outcome data were compared with the first national ROP inventory (NEDROP-1, 2009).

RESULTS

In 2017, 1492 infants were live born with gestational age (GA) <32 weeks (2009: 1662); 1287 infants were eligible for screening (2009: 2033). Ophthalmologists screened 1085 infants, versus 1688 in 2009, corrected with factor 1.114 for the difference in number of live births, a 28.4% (479/1688) decrease in screened infants was seen. Among surviving infants with GA <32 week, ROP was found in 305/1492 babies, 20.4% (2009: 324/1662, 19.5%) of which 49/1492 stage ≥3, 3.3% (2009: 30/1662, 1.8%). In all infants, report on presence or absence of plus disease was provided, according to the ETROP criteria. Treatment was performed in 39 infants. Of infants with ROP stage ≥3, 3/49 (6.1%) progressed to retinal detachment (2009: 6/30, 20.0%).

CONCLUSION

The overall ROP incidence expressed as a percentage, remained stable but the number of infants that developed severe ROP nearly doubled. A near one-third reduction in screened infants shows satisfactory implementation of the new screening criteria. A notable decrease in retinal detachment delineates improved treatment outcome.

摘要

目的

提供关于早产儿视网膜病变(ROP)发病率的最新见解,介绍荷兰的 ROP 筛查和治疗流程,并讨论新的国家 ROP 指南的影响,该指南实施了更为严格的筛查标准和早期 ROP 治疗(ETROP)标准。

方法

本研究为一项多中心前瞻性全国性研究,纳入了 2017 年在荷兰出生且被认为适合 ROP 筛查的所有极早产儿。合并眼科医生和儿科医生的匿名数据。将结果数据与第一份国家 ROP 登记册(NEDROP-1,2009 年)进行比较。

结果

2017 年,共有 1492 名胎龄(GA)<32 周的婴儿活产(2009 年:1662 名),其中 1287 名婴儿有资格进行筛查(2009 年:2033 名)。与 2009 年相比,眼科医生对 1085 名婴儿进行了筛查(校正活产儿数量差异的因子为 1.114),筛查婴儿的数量减少了 28.4%(479/1688)。在存活的 GA<32 周的婴儿中,ROP 发现于 305/1492 名婴儿中,占 20.4%(2009 年:324/1662 名,19.5%),其中 49/1492 名婴儿为≥3 期 ROP,占 3.3%(2009 年:30/1662 名,1.8%)。根据 ETROP 标准,所有婴儿均报告了 PLUS 病的存在或缺失。39 名婴儿接受了治疗。在 ROP 分期≥3 期的婴儿中,有 3/49(6.1%)进展为视网膜脱离(2009 年:30/30,20.0%)。

结论

以百分比表示的总体 ROP 发病率保持稳定,但发展为严重 ROP 的婴儿数量几乎翻了一番。筛查婴儿数量减少近三分之一表明新的筛查标准得到了满意的实施。视网膜脱离数量的显著减少表明治疗效果得到了改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac4d/10176329/a2278c7d689f/bjophthalmol-2021-319929f01.jpg

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