Simpson Alasdair Innes, McAllister Emma, Hamilton Ruth, Wright Jacqueline, Millar Eoghan
Tennent Institute of Ophthalmology, Glasgow, UK
University of Glasgow, Glasgow, UK.
BMJ Open Ophthalmol. 2024 Dec 20;9(1):e001874. doi: 10.1136/bmjophth-2024-001874.
Very premature infants screened for retinopathy of prematurity (ROP) that do not develop ROP still experience serious visual developmental challenges, and while it is recommended that all children in the UK are offered preschool visual screening, we aimed to explore whether this vulnerable group requires dedicated follow-up.
We performed a real-world retrospective observational cohort study of children previously screened for ROP in NHS Greater Glasgow and Clyde (Scotland) between 2013 and 2015. We excluded those with any severity of ROP identified during screening. Electronic patient records were searched for preschool orthoptic visual screening (See4School) results and results of referral to the hospital eye service (HES).
222 children met the inclusion criteria. Their median birth weight was 1200 g and median gestational age was 31 weeks. A total of 111 (50%) of these children had been referred to HES nationally. 103 were referred within the health board where ROP screening took place; of these, 47% (48/103) were referred from the See4School programme, 31% (31/103) from paediatric clinics, 13% (13/103) from primary care and 11% (11/103) from community optometrists. 42 of these 103 referrals (41%) to HES had occurred before the age (3½ years) when children became eligible for See4School screening. At hospital review, 55% (55/99) patients had a glasses prescription issued for refractive error, 22% were estimated to have amblyopia and 30% had a diagnosis of strabismus.
In this non-controlled study we found premature infants that do not develop ROP still face considerable visual morbidity and dedicated follow-up may be warranted.
接受早产儿视网膜病变（ROP）筛查但未患ROP的极早产儿仍面临严重的视觉发育挑战，虽然建议为英国所有儿童提供学龄前视力筛查，但我们旨在探讨这一弱势群体是否需要专门的随访。
我们对2013年至2015年期间在苏格兰大格拉斯哥和克莱德国民保健服务局接受过ROP筛查的儿童进行了一项真实世界的回顾性观察队列研究。我们排除了筛查期间发现患有任何严重程度ROP的儿童。通过电子病历搜索学龄前斜视弱视视觉筛查（See4School）结果以及转介至医院眼科服务（HES）的结果。
222名儿童符合纳入标准。他们的中位出生体重为1200克，中位孕周为31周。这些儿童中共有111名（50%）被全国转介至HES。103名在进行ROP筛查的健康委员会辖区内被转介；其中，47%（48/103）来自See4School项目，31%（31/103）来自儿科诊所，13%（13/103）来自初级保健机构，11%（11/103）来自社区验光师。这103名转介至HES的儿童中，有42名（41%）在儿童符合See4School筛查条件的年龄（3.5岁）之前就已被转介。在医院复查时，55%（55/99）的患者因屈光不正开具了眼镜处方，22%的患者估计患有弱视，30%的患者被诊断为斜视。
在这项非对照研究中，我们发现未患ROP的早产儿仍面临相当大的视觉疾病负担，可能需要进行专门的随访。
