Zhu X M, Ye Q B, Long H Y, Ciren B C R, Yu Z, Han T Y, Liang J H
Department of Ophthalmology, Lhasa People's Hospital, Lhasa 850000, China.
Department of Pediatrics, Lhasa People's Hospital, Lhasa 850000, China.
Zhonghua Yan Ke Za Zhi. 2025 May 11;61(5):351-357. doi: 10.3760/cma.j.cn112142-20250102-00003.
To investigate the incidence and clinical features of retinopathy of prematurity (ROP) among preterm infants in a neonatal intensive care unit (NICU) of Lhasa, and to explore the screening criteria for ROP in high-altitude areas. It was a single-center retrospective case study. A total of 166 preterm infants of Tibetan ethnicity admitted to the NICU of Lhasa People's Hospital from May 1, 2020 to June 1, 2022 with a gestational age<36 weeks were enrolled. ROP was screened using the third-generation wide-angle digital pediatric retinal imaging system (RetCam Ⅲ). The ROP detection rate, staging, and zonal distribution were analyzed. Multivariate logistic regression was performed and risk factors for ROP in preterm infants were identified by calculating the odds ratio () and its 95% confidence interval (95%). There were 88 males and 78 females, among whom 33 patients (66 eyes) were diagnosed with ROP. The birth gestational age of ROP patients was 30 (29, 31) weeks, and the average birth weight was 1 188.5±219.2 g. The disease was at stage 1 in 48 eyes (72.7%), stage 2 in 16 eyes (24.2%), and stage 3 in 2 eyes (3.0%). Two eyes (3.0%) had zone Ⅰ disease, 26 eyes (39.4%) had zone Ⅱ disease, and 38 eyes (57.6%) had zone Ⅲ disease. Thirty ROP patients (90.9%) had spontaneous regression and vascularization. Three patients (9.1%) developed type Ⅰ ROP, which was treated by anti-VEGF therapy (1 patient) or spontaneously resolved during the follow-up (2 patients). Multiple logistic regression analysis showed that gestational age (=0.53, 95%: 0.33-0.84, =0.007), birth weight (=0.95, 95%: 0.92-0.98, <0.001), and duration of invasive mechanical ventilation (=1.42, 95%: 1.06-1.90, =0.018) were influencing factors of ROP. The detection rate of ROP among Tibetan preterm infants in the single-center neonatal intensive care unit in Lhasa was 19.9%, while the detection rate of type Ⅰ ROP was 1.8%. Preterm infants with shorter gestational age, lower birth weight, and prolonged invasive mechanical ventilation were liable to develop ROP.
调查拉萨市某新生儿重症监护病房(NICU)早产儿视网膜病变(ROP)的发病率及临床特征,探索高海拔地区ROP的筛查标准。这是一项单中心回顾性病例研究。纳入2020年5月1日至2022年6月1日期间入住拉萨市人民医院NICU的166例藏族早产儿,其胎龄<36周。采用第三代广角数字化小儿视网膜成像系统(RetCamⅢ)进行ROP筛查。分析ROP检出率、分期及区域分布情况。进行多因素logistic回归分析,通过计算比值比(OR)及其95%置信区间(95%CI)确定早产儿ROP的危险因素。其中男88例,女78例,33例(66眼)诊断为ROP。ROP患儿出生胎龄为30(29,31)周,平均出生体重为1 188.5±219.2 g。疾病处于1期48眼(72.7%),处于2期16眼(24.2%),处于3期2眼(3.0%)。2眼(3.0%)为Ⅰ区病变,26眼(39.4%)为Ⅱ区病变,38眼(57.6%)为Ⅲ区病变。30例ROP患儿(90.9%)自发消退并血管化。3例(9.1%)发生Ⅰ型ROP,其中1例接受抗VEGF治疗,2例在随访期间自发缓解。多因素logistic回归分析显示,胎龄(OR=0.53,95%CI:0.33-0.84,P=0.007)、出生体重(OR=0.95,95%CI:0.92-0.98,P<0.001)及有创机械通气时间(OR=1.42,95%CI:1.06-1.90,P=0.