Schaffer D B, Palmer E A, Plotsky D F, Metz H S, Flynn J T, Tung B, Hardy R J
Department of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia.
Ophthalmology. 1993 Feb;100(2):230-7. doi: 10.1016/s0161-6420(93)31665-9.
There exists no reliable information that allows the ophthalmologist to predict with any degree of certainty a particular infant's chances of requiring surgical treatment for retinopathy of prematurity (ROP) or of reaching an unfavorable outcome on the basis of the retinal findings at the time of the nursery examination.
In the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP), 4099 infants weighing less than 1251 g at birth underwent eye examinations that began at 4 to 6 weeks after birth and subsequently continued at 2-week intervals. Independent variables in the population were studied using multiple logistic regressions.
An increased risk of reaching threshold ROP was found associated with lower birth weights, younger gestational age, white race, multiple birth, and being born outside a study center nursery. For infants who developed ROP (66%), corresponding probabilities are presented for developing severe ("threshold") ROP or of having an unfavorable macular outcome. The risk of an unfavorable macular outcome was increased with zone 1 ROP, "plus" disease, the severity of the stage, and the amount of circumferential involvement. A higher risk also was associated with a rapid rate of progression of ROP to prethreshold disease but not with the postconceptional age at which ROP was first noted.
The findings indicate that the ocular characteristics of ROP, along with some easily identifiable and available basic systemic and demographic information about an infant, can assist the ophthalmologist in understanding variations in an individual baby's chance for a good or poor macular outcome.
目前尚无可靠信息能让眼科医生根据新生儿病房检查时的视网膜表现，确定地预测某一特定婴儿发生早产儿视网膜病变（ROP）而需要手术治疗的几率，或预测其预后不良的可能性。
在早产儿视网膜病变冷冻治疗多中心试验（CRYO-ROP）中，4099名出生体重小于1251克的婴儿在出生后4至6周开始接受眼科检查，随后每2周进行一次。使用多元逻辑回归研究总体中的自变量。
发现出生体重较低、胎龄较小、白人种族、多胎以及在非研究中心新生儿病房出生与达到阈值ROP的风险增加有关。对于发生ROP的婴儿（66%），给出了发生严重（“阈值”）ROP或黄斑预后不良的相应概率。黄斑预后不良的风险随着1区ROP、“plus”病变、病变阶段的严重程度以及圆周受累程度的增加而增加。ROP快速进展至阈值前病变也与较高风险相关，但与首次发现ROP时的孕龄无关。
研究结果表明，ROP的眼部特征，以及一些关于婴儿的易于识别和获取的基本全身及人口统计学信息，可帮助眼科医生了解个体婴儿黄斑预后良好或不良几率的差异。
