Department of General Surgery and Surgical Specialties, AOU Policlinico-San Marco, University of Catania, via S. Sofia 78, 95100 Catania, Italy.
Integrated Activity Department for the Protection of Mother and Child Health, Neonatal Intensive Care Unit, AOU Policlinico-San Marco, University of Catania, via S. Sofia 78, 95100 Catania, Italy.
Early Hum Dev. 2023 Oct;185:105844. doi: 10.1016/j.earlhumdev.2023.105844. Epub 2023 Aug 19.
To evaluate Retinopathy of Prematurity (ROP) rate and risk factors in a large cohort of preterm newborns.
Single center retrospective study. All preterm inborn hospitalized at the Neonatal Intensive Care Unit of the Policlinico of Catania from January 1, 2009 till December 31, 2018, were included. ROP stage and location, treatments required, maternal and infant risk factors were evaluated.
Medical records of 898 preterms were retrospectively examined (mean gestational age 32.9 ± 2.3 weeks). Of them 149 (16.6 %) developed bilateral ROP (92 stage 1, 44 stage 2 and 13 stage 3); 66 (7.3 %) received bilateral laser treatment. Six eyes of three patients affected by zone I ROP 1, with plus persistence 15 days after an optimal laser treatment, also received intravitreal ranibizumab injection. Risk factors for ROP development were gestational age (GA) (p < 0.001), birthweight (p < 0.001), assisted ventilation duration (p < 0.001), multiple birth (p = 0.003), erythropoietin (EPO) administration (p = 0.005) and persistence of tunica vasculosa lentis. The decision-tree analysis showed gestational age as the most significant predictive factor (P < 0.001); secondary predictive factors were EPO administration (p = 0.001) in newborns 29-31 weeks GA and birthweight lower than 2090 g (p < 0.001) in 32-34 weeks GA; in this latter group patent ductus arteriosus (PDA) was a tertiary predictive factor (p = 0.043).
In our study ROP incidence was 16,6 %; 7.3 % of the patients required laser treatment. Besides well-known factors, such as GA and birthweight, other factors like duration of assisted ventilation, EPO, multiple births, PDA, tunica vasculosa lentis persistence should be considered to tailor ophthalmic evaluation and follow-up.
评估大型早产儿队列中早产儿视网膜病变（ROP）的发生率和危险因素。
单中心回顾性研究。纳入 2009 年 1 月 1 日至 2018 年 12 月 31 日期间在卡塔尼亚综合医院新生儿重症监护病房住院的所有早产儿。评估 ROP 分期和位置、所需治疗、母婴危险因素。
回顾性检查了 898 名早产儿的病历（平均胎龄 32.9 ± 2.3 周）。其中 149 例（16.6%）出现双眼ROP（92 例 1 期，44 例 2 期，13 例 3 期）；66 例（7.3%）接受了双眼激光治疗。3 名患者的 6 只眼患有 I 区 ROP1，在最佳激光治疗后 15 天仍有 plus 期，还接受了玻璃体内雷珠单抗注射。ROP 发生的危险因素是胎龄（GA）（p<0.001）、出生体重（p<0.001）、辅助通气时间（p<0.001）、多胎（p=0.003）、促红细胞生成素（EPO）治疗（p=0.005）和晶状体血管膜残留。决策树分析显示，GA 是最显著的预测因素（P<0.001）；次要预测因素是 29-31 周 GA 新生儿 EPO 治疗（p=0.001）和 32-34 周 GA 时出生体重低于 2090 g（p<0.001）；后者中，动脉导管未闭（PDA）是一个三级预测因素（p=0.043）。
在我们的研究中，ROP 发生率为 16.6%；7.3%的患者需要激光治疗。除了已知的因素，如 GA 和出生体重，其他因素，如辅助通气时间、EPO、多胎、PDA、晶状体血管膜残留，也应考虑用于定制眼科评估和随访。
