Maheshwari R, Kumar H, Paul V K, Singh M, Deorari A K, Tiwari H K
Department of Paediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Natl Med J India. 1996 Sep-Oct;9(5):211-4.
Retinopathy of prematurity (RoP) has become more common in developed countries with an improvement in survival of very premature infants. Though previously rare, it is likely to emerge as a major problem in India because of improving outcome of 'at-risk' preterm infants.
In a prospective study we estimated the incidence of RoP among at-risk neonates in a tertiary care unit. Infants with birth-weights of < 1500 g, gestation < 35 weeks and preterm neonates who required supplemental oxygen for > 24 hours were subjected to periodic ophthalmological evaluation for detection of RoP until full retinal vascularization occurred.
Sixty-six eligible infants completed the full protocol during the 15-month study period. The incidence of RoP was 20% in the cohort and 27% among the very low birth-weight neonates. The incidence of threshold RoP was 7% in the cohort. The occurrence of RoP was inversely related to the gestation and birth-weight. RoP typically developed at the post-conceptional age of 32-35 weeks. Blood transfusion and clinical sepsis emerged as independent risk factors of RoP on step-wise logistic regression analysis. Cryotherapy undertaken in 5 cases (9 eyes) led to amelioration of the changes of RoP.
The incidence of RoP in our neonates was lower than that reported from other centres. Blood transfusion and clinical sepsis are risk factors for RoP in our newborn infants.
随着极早产儿存活率的提高，早产儿视网膜病变（ROP）在发达国家已变得更为常见。尽管以前罕见，但由于“高危”早产儿的预后改善，ROP在印度可能会成为一个主要问题。
在一项前瞻性研究中，我们估计了三级医疗单位中高危新生儿ROP的发病率。出生体重<1500g、孕周<35周以及需要补充氧气超过24小时的早产儿接受定期眼科评估以检测ROP，直至视网膜完全血管化。
在15个月的研究期间，66名符合条件的婴儿完成了整个方案。该队列中ROP的发病率为20%，极低出生体重新生儿中为27%。阈值ROP的发病率在该队列中为7%。ROP的发生与孕周和出生体重呈负相关。ROP通常在孕龄32 - 35周时发生。在逐步逻辑回归分析中，输血和临床败血症成为ROP的独立危险因素。5例（9只眼）进行的冷冻治疗使ROP的病变得到改善。
我们新生儿中ROP的发病率低于其他中心报道的发病率。输血和临床败血症是我们新生儿ROP的危险因素。
