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在土耳其一家三级医疗中心采用回顾性队列研究对早产儿视网膜病变筛查更新情况进行评估。

Evaluation of the update for screening for retinopathy of prematurity in a tertiary care center in Türkiye with retrospective cohorts.

作者信息

Kaya Güner Emine, Inci Bozbiyik Duygu

机构信息

Department of Ophthalmology, Faculty of Medicine, University of Health Sciences, Tepecik Research and Training Hospital, İzmir, Turkiye.

出版信息

Turk J Med Sci. 2024 Oct 20;54(6):1295-1301. doi: 10.55730/1300-0144.5912. eCollection 2024.

Abstract

BACKGROUND/AIM: In Türkiye, the recommendations for screening for retinopathy of prematurity (ROP) were updated in 2021. We aimed to present detailed data on the infants included in the screening program according to the new criteria and evaluate whether these changes are of benefit in detecting severe ROP.

MATERIALS AND METHODS

Our hospital's medical records of infants screened for ROP between July 2019 and July 2021 or between August 2021 and August 2023 were retrospectively examined. Gestational age (GA), birth weight, the sex of the infant, whether there was multiple pregnancy, ROP examination results, the most advanced ROP level and time, and ROP treatment needs and times were recorded. Cohort data from these two time periods before and after the update were compared.

RESULTS

Three hundred and fifty-seven infants screened before the updating of the guidelines and 336 infants screened after the update were included in the analysis. Between August 2021 and August 2023, more cases of ROP were detected (19.3% and 21.4% for the two cohorts, respectively), while a lower rate of treatment was required (3.9% and 2.1% for the cohorts, respectively). One of the infants treated after the update was included in the screening based on the new GA criterion. In both cohorts, no infant needed treatment before 32 weeks of postmenstrual age regardless of agreement with GA at birth.

CONCLUSION

In this study, one infant in need of treatment who was not included in the screening program according to the previous criteria was identified. The data we obtained support the necessity of increasing the upper limit for GA. Additionally, the 31st week seems safe for the beginning of examinations in extremely premature infants.

摘要

背景/目的:在土耳其,早产儿视网膜病变(ROP)筛查建议于2021年更新。我们旨在根据新标准提供筛查项目中纳入婴儿的详细数据,并评估这些变化是否有利于检测重度ROP。

材料与方法

回顾性检查我院2019年7月至2021年7月或2021年8月至2023年8月期间接受ROP筛查婴儿的病历。记录胎龄(GA)、出生体重、婴儿性别、是否为多胎妊娠、ROP检查结果、最严重的ROP级别和时间以及ROP治疗需求和时间。比较更新前后这两个时间段的队列数据。

结果

分析纳入了指南更新前筛查的357例婴儿和更新后筛查的336例婴儿。在2021年8月至2023年8月期间,检测到的ROP病例更多(两个队列分别为19.3%和21.4%),而所需治疗率较低(队列分别为3.9%和2.1%)。更新后接受治疗的婴儿中有1例是根据新的GA标准纳入筛查的。在两个队列中,无论出生时与GA是否相符,在孕龄32周之前均无婴儿需要治疗。

结论

在本研究中,确定了1例根据先前标准未纳入筛查项目但需要治疗的婴儿。我们获得的数据支持提高GA上限的必要性。此外,对于极早产儿,第31周似乎是开始检查的安全时间。

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本文引用的文献

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International Classification of Retinopathy of Prematurity, Third Edition.国际早产儿视网膜病变分类,第三版。
Ophthalmology. 2021 Oct;128(10):e51-e68. doi: 10.1016/j.ophtha.2021.05.031. Epub 2021 Jul 8.
9
Operational guidelines for ROP in India: A summary.印度早产儿视网膜病变(ROP)临床操作指南:概述。
Indian J Ophthalmol. 2020 Feb;68(Suppl 1):S108-S114. doi: 10.4103/ijo.IJO_1827_19.

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