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荷兰早产儿视网膜病变导致的视力障碍及伴发残疾。

Visual impairment due to retinopathy of prematurity and concomitant disabilities in the Netherlands.

机构信息

Leiden University Medical Center, Leiden, Netherlands.

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

出版信息

Early Hum Dev. 2023 Jul;182:105793. doi: 10.1016/j.earlhumdev.2023.105793. Epub 2023 May 29.

Abstract

AIM

Determine incidence of visual impairment due to retinopathy of prematurity (ROP) and concomitant disabilities between 2009 and 2018 in the Netherlands and compare data to four former similar studies. Secondly, monitor if infants were missed for ROP-screening since the adoption of stricter, risk factor guided criteria (2013).

METHODS

Retrospective inventory on anonymous data of infants diagnosed with ROP from Dutch visual impairment-institutes. Data including: best corrected visual acuity, ROP-treatment and concomitant disabilities: bronchopulmonary dysplasia, behavioral abnormalities, epilepsy, hearing deficit, developmental delay, cerebral palsy and cerebral visual impairment. During the study period, lower age limit for neonatal life support (2010) and higher oxygen saturation targets (2014) were implemented.

RESULTS

Records of 53 infants were analyzed. Visual impairment incidence due to ROP was 2.02 per 100.000 live births (2000-2009: 1.84, p = 0.643). Compared to earlier periods (1975-2000), a significant decrease was observed. The incidence of concomitant disabilities remained stable. Mean gestational age (GA) continued to decrease to 26.6 ± 1.9 weeks (2000-2009: 27.4 ± 2.0 weeks, p = 0.047). All patients met the screening inclusion criteria.

CONCLUSION

The incidence of visual impairment due to ROP and concomitant disabilities between 2009 and 2018 has not increased, despite lower GA and higher oxygen saturation targets. None of the infants were missed for ROP screening following introduction of more restricted screening inclusion criteria.

摘要

目的

确定 2009 年至 2018 年荷兰早产儿视网膜病变(ROP)引起的视力障碍和并发残疾的发生率,并将数据与四项以前的类似研究进行比较。其次,监测自采用更严格、基于危险因素的筛查标准(2013 年)以来,ROP 筛查是否遗漏了婴儿。

方法

对荷兰视力障碍研究所诊断为 ROP 的婴儿的匿名数据进行回顾性库存调查。数据包括:最佳矫正视力、ROP 治疗和并发残疾:支气管肺发育不良、行为异常、癫痫、听力缺陷、发育迟缓、脑瘫和脑性视觉障碍。在研究期间,新生儿生命支持的下限年龄(2010 年)和更高的氧饱和度目标(2014 年)得到了实施。

结果

对 53 名婴儿的记录进行了分析。ROP 引起的视力障碍发生率为每 10 万活产儿 2.02 例(2000-2009 年:1.84,p=0.643)。与早期相比(1975-2000 年),发生率显著下降。并发残疾的发生率保持稳定。平均胎龄(GA)继续下降至 26.6±1.9 周(2000-2009 年:27.4±2.0 周,p=0.047)。所有患者均符合筛查纳入标准。

结论

尽管 GA 降低和氧饱和度目标升高,但 2009 年至 2018 年间,ROP 引起的视力障碍和并发残疾的发生率并未增加。采用更严格的筛查纳入标准后,无一例婴儿漏诊 ROP 筛查。

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