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早产儿视网膜病变诊所就诊患者的人口统计学特征、筛查及管理研究

A Study of the Demographic Profile, Screening, and Management of Patients Visiting a Retinopathy of Prematurity Clinic.

作者信息

Mushtaq Iqra, Agrawal Tushar, Bhavsar Deepaswi, Choudhary Shaili, Bakare Prachi N

机构信息

Ophthalmology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, IND.

Ophthalmology, Post Graduate Institute, Yashwantrao Chavan Memorial Hospital, Pune, IND.

出版信息

Cureus. 2024 Apr 15;16(4):e58305. doi: 10.7759/cureus.58305. eCollection 2024 Apr.

Abstract

Background and objective Retinopathy of prematurity (ROP) is a retinal vasoproliferative disease affecting premature infants. Despite improvements in neonatal care and management, ROP still remains a major cause of childhood blindness worldwide. Studying the demographic profile and screening is essential to develop predictive models, to gain insights into the cause of retinal vascular diseases and diseases of prematurity, and to determine the future management and research in ROP. The objective of the present study was to estimate the incidence of ROP, to identify the risk factors that predispose to ROP, and to assess the outcome of these cases. Hence, this study was conducted in a tertiary care hospital in Maharashtra. Method A prospective, observational study was conducted from 10 August 2022 to 10 October 2022. Infants with gestational ages < 34 weeks, birth weights < 2000 g, infants who received supplemental oxygen therapy, or patients who required NICU stay were screened for ROP. Demographic details were recorded to assess the risk factors and treatment was given according to the severity of ROP grade. Result A total of 160 eyes of 80 infants were screened and analysed. The overall incidence of "any ROP" was 19 patients (38 eyes), i.e., 24%. Out of 80 patients, six were of 28 weeks gestational age, of whom four (67%) were positive for ROP. The mean birth weight of infants with ROP was 1331.58 ± 238.532 g (p < 0.0001). ROP stage 1 was seen in five patients (26.32%), stage 2 in 10 patients (52.63%), and stage 3 in four patients (21.0%), with no subjects in stages 4 & 5. Out of 19 patients, six (32%) had type 1 ROP, and 13 (68%) had type 2 ROP. Out of 19 cases, 13 (68%) received follow-up care based on the severity of their disease, and six (32%) were treated with panretinal photocoagulation (PRP) laser. Conclusion Incidence of any ROP was 24%. Prematurity, low birth weight, and oxygen therapy remain the most significant risk factors associated with the development of ROP. Early referral, diagnosis, and timely intervention will play a monumental role in improving the prognosis of this potentially blinding disease.

摘要

背景与目的 早产儿视网膜病变(ROP)是一种影响早产儿的视网膜血管增生性疾病。尽管新生儿护理和管理有所改善,但ROP仍是全球儿童失明的主要原因。研究人口统计学特征和筛查对于开发预测模型、深入了解视网膜血管疾病和早产相关疾病的病因以及确定ROP未来的管理和研究至关重要。本研究的目的是估计ROP的发病率,确定易患ROP的危险因素,并评估这些病例的结局。因此,本研究在马哈拉施特拉邦的一家三级护理医院进行。方法 于2022年8月10日至2022年10月10日进行了一项前瞻性观察研究。对孕周<34周、出生体重<2000g、接受过补充氧气治疗的婴儿或需要入住新生儿重症监护病房(NICU)的患者进行ROP筛查。记录人口统计学细节以评估危险因素,并根据ROP分级的严重程度进行治疗。结果 共筛查和分析了80例婴儿的160只眼。“任何ROP”的总体发病率为19例患者(38只眼),即24%。在80例患者中,6例孕周为28周,其中4例(67%)ROP呈阳性。ROP婴儿的平均出生体重为1331.58±238.532g(p<0.0001)。1期ROP见于5例患者(26.32%),2期见于10例患者(52.63%),3期见于4例患者(21.0%),4期和5期无病例。在19例患者中,6例(32%)为1型ROP,13例(68%)为2型ROP。在19例病例中,13例(68%)根据疾病严重程度接受了随访护理,6例(32%)接受了全视网膜光凝(PRP)激光治疗。结论 任何ROP的发病率为24%。早产、低出生体重和氧气治疗仍然是与ROP发生相关的最重要危险因素。早期转诊、诊断和及时干预将在改善这种潜在致盲疾病的预后方面发挥巨大作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06c5/11095133/6ceb07031b23/cureus-0016-00000058305-i01.jpg

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