Lai Tso-Ting, Yang Chung-May, Hsieh Yi-Ting, Yeh Po-Ting, Huang Ching-Wen, Tsai Chia-Ying
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Retina. 2023 Jan 1;43(1):102-110. doi: 10.1097/IAE.0000000000003627.
To evaluate the rate of and time to complete vascularization in premature infants and to explore associated factors.
A monocentric, retrospective cohort study including 541 premature infants who underwent screening for retinopathy of prematurity (ROP) between July 2016 and June 2019. Patients underwent regular dilated fundus examinations with indirect ophthalmoscopy until complete vascularization. The worse eye of each patient was included for analyses. The proportion of infants with complete retinal vascularization at the last visit and the time to full vascularization was analyzed.
Among all infants (average gestational age 31.29 ± 3.12 weeks), 490 (90.57%) had complete records of retinal vascularization outcomes, of whom 439 (89.59%) achieved complete vascularization. The average postmenstrual age for complete vascularization was 45.39 ± 11.04 weeks, and 95.22% achieved completion before 64 weeks of postmenstrual age. Retinopathy of prematurity developed in 118 (22.56%) infants; 33 (6.10%) received antivascular endothelial growth factor treatment. For all infants screened for ROP, lower birth weight, presence of ROP, and antivascular endothelial growth factor therapy predicted delayed complete vascularization; for infants diagnosed with ROP, only lower birth weight predicted delayed complete vascularization. Subgroup analysis showed significant differences between patients without ROP, with untreated ROP, and with treated ROP in time to complete vascularization and its rate (99.7%, 66.2%, and 16.7%, respectively).
Lower birth weight predicted delayed complete vascularization. Antivascular endothelial growth factor therapy and the presence of ROP, including ROP severity, may also affect time to complete vascularization. These findings should help improve the understanding and management of persistent avascular retina in preterm infants.
评估早产儿视网膜完全血管化的发生率和所需时间，并探讨相关因素。
一项单中心回顾性队列研究，纳入了2016年7月至2019年6月期间接受早产儿视网膜病变（ROP）筛查的541例早产儿。患者接受定期散瞳眼底间接检眼镜检查，直至视网膜完全血管化。分析时纳入每位患者病情较重的那只眼睛。分析了末次随访时视网膜完全血管化婴儿的比例以及完全血管化所需时间。
在所有婴儿（平均胎龄31.29±3.12周）中，490例（90.57%）有完整的视网膜血管化结果记录，其中439例（89.59%）实现了完全血管化。完全血管化时的平均孕龄为45.39±11.04周，95.22%在孕龄64周前实现完全血管化。118例（22.56%）婴儿发生了早产儿视网膜病变；33例（6.10%）接受了抗血管内皮生长因子治疗。对于所有接受ROP筛查的婴儿，较低的出生体重、ROP的存在以及抗血管内皮生长因子治疗预示着完全血管化延迟；对于诊断为ROP的婴儿，只有较低的出生体重预示着完全血管化延迟。亚组分析显示，未患ROP、未治疗的ROP以及接受治疗的ROP患者在完成血管化的时间及其发生率方面存在显著差异（分别为99.7%、66.2%和16.7%）。
较低的出生体重预示着完全血管化延迟。抗血管内皮生长因子治疗以及ROP的存在，包括ROP的严重程度，也可能影响完全血管化的时间。这些发现应有助于提高对早产儿持续性无血管视网膜的认识和管理。
