[11至14岁前早产儿的眼部检查结果]

Seiberth V, Freiwald R, Knorz M C, Liesenhoff H

Universität-Augenklinik Klinikum Mannheim, Fakultät für Klinische Medizin der Ruprecht-Karls-Universität Heidelberg.

Klin Monbl Augenheilkd. 1994 Jun;204(6):513-7. doi: 10.1055/s-2008-1045475.

BACKGROUND

Functional disturbances as well as morphologic changes can be various in regressed retinopathy of prematurity (ROP).

PATIENTS AND METHODS

To investigate the incidence and the degree of such changes, we examined prematurely born infants in the age of 11 to 14 years. Of the 142 prematures (birthweight < or = 2000 g), who were cared for in their first weeks of life in the University Children's Hospital at the Klinikum Mannheim in 1977 to 1979, 48 could be reexamined.

RESULTS

Of 48 infants (mean birth weight 1808 +/- 211 g, gestational age 34.6 +/- 3.1 weeks) six (12.5%; birth weight 1742 +/- 218 g, gestational age 32.2 +/- 2.5) had had acute ROP (stage 2 or 3). When reexamined in school age 10 (21%) of the children had physical deficits. Eight (17%) visited a school for handicapped children. Eight (17%) children had a squint. In 13 out of 96 (14%) eyes visual acuity was reduced to 0.8 or less. Thirteen eyes (14%) were emmetropic, 67 (70%) hyperopic, 16 (17%) myopic and 15 (16%) astigmatic. The intraocular pressure was normal in all eyes (15 +/- 4 mm Hg). The anterior segments did not show findings caused by ROP. The fundus findings in the 12 eyes, in which the diagnosis of acute ROP was established in the first weeks of life, showed in 5 (42%) eyes a slightly reduced angle kappa between the vascular arcades and avascular retina in the temporal fundus periphery in all of the 12 (100%) eyes. In 1 (8%) eye the retinal periphery showed extensive scarring after cryotherapy because of acute ROP. None of the eyes which had had acute ROP showed macular ectopia or retinal folds (amotio falciformis). In 16 of the 84 (19%) eyes, which did not have a history of acute ROP, minor changes of the retinal periphery, the peripheral retinal vessels and the pigment epithelium were present, which were caused by prematurity.

CONCLUSION

Prematurely born infants examined in school age, who were comparatively mature preterms at birth (mean birth weight 1800 g; mean gestational age 34.6 weeks), did not show a higher risk of refractive errors, i.e. myopia. However, they were at higher risk having squint. The functional disturbances found in the prematurely born infants in this study were not caused by morphologic changes due to ROP.

背景

在退行性早产儿视网膜病变（ROP）中，功能障碍以及形态学改变可能多种多样。

患者与方法

为了研究此类变化的发生率和程度，我们对11至14岁的早产婴儿进行了检查。在1977年至1979年于曼海姆大学儿童医院接受最初几周护理的142名早产儿（出生体重≤2000g）中，有48名可以接受复查。

结果

在48名婴儿（平均出生体重1808±211g，胎龄34.6±3.1周）中，有6名（12.5%；出生体重1742±218g，胎龄32.2±2.5周）曾患急性ROP（2期或3期）。在学龄期复查时，10名（21%）儿童有身体缺陷。8名（17%）就读于残疾儿童学校。8名（17%）儿童有斜视。在96只眼中，有13只（14%）视力降至0.8或更低。13只眼（14%）为正视眼，67只（70%）为远视眼，16只（17%）为近视眼，15只（16%）为散光眼。所有眼睛的眼压均正常（15±4mmHg）。眼前节未显示由ROP引起的病变。在出生后最初几周确诊为急性ROP的12只眼中，有5只（42%）眼在所有12只（100%）眼中，颞侧眼底周边血管弓与无血管视网膜之间的kappa角略有减小。在1只（8%）眼中，由于急性ROP，视网膜周边在冷冻治疗后出现广泛瘢痕形成。曾患急性ROP的眼睛均未出现黄斑异位或视网膜折叠（镰状视网膜脱离）。在84只无急性ROP病史的眼中，有16只（19%）眼存在视网膜周边、周边视网膜血管和色素上皮的轻微改变，这些改变是由早产引起的。