Saunders R A, Donahue M L, Christmann L M, Pakalnis A V, Tung B, Hardy R J, Phelps D L
N. Edgar Miles Center for Pediatric Ophthalmology, Department of Ophthalmology, Medical University of South Carolina, Charleston, USA.
Arch Ophthalmol. 1997 May;115(5):604-8. doi: 10.1001/archopht.1997.01100150606005.
To determine and compare the incidence of severe, vision-threatening retinopathy of prematurity (ROP) in black and white low-birth-weight infants.
Prospective cohort study.
Seventy neonatal intensive care units in 23 US participating centers in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity.
A total of 4099 premature infants weighing less than 1251 g at birth were enrolled to evaluate the natural history of ROP. This 'Natural History' cohort included 2158 white infants and 1584 black infants who were followed up prospectively according to a Natural History protocol.
Incidence and severity of acute ROP.
While ROP occurred with similar frequency in all racial subgroups, severe ROP was less common in black infants. One hundred sixty (7.4%) of 2158 white infants reached threshold ROP (defined as at least 5 contiguous or 8 cumulative clock-hours of stage 3 retinopathy in zone 1 or zone 2 in the presence of "plus disease" [dilation and tortuosity of the posterior pole blood vessels]), but only 51 (3.2%) of 1584 black infants progressed to threshold ROP. Using multiple logistic regression analysis, race emerged as a highly significant factor (P < .001) in the development of threshold disease, even when birth weight, gestational age status at delivery, sex, multiple births, and transport status were considered.
Severe, vision-threatening ROP occurs with greater frequency in low-birth-weight white infants than in low-birth-weight black infants who are seemingly at equivalent risk. The reason for this disparity is unknown. We speculate that differences in retinal pigmentation may confer relative protection against free radical-mediated phototoxic injury in black infants.
确定并比较黑白种族低出生体重婴儿中严重的、威胁视力的早产儿视网膜病变（ROP）的发生率。
前瞻性队列研究。
美国23个参与中心的70个新生儿重症监护病房，参与早产儿视网膜病变冷冻治疗多中心试验。
共纳入4099例出生时体重小于1251g的早产儿，以评估ROP的自然病程。这个“自然病程”队列包括2158例白人婴儿和1584例黑人婴儿，他们按照自然病程方案进行前瞻性随访。
急性ROP的发生率和严重程度。
虽然ROP在所有种族亚组中的发生频率相似，但严重ROP在黑人婴儿中较少见。2158例白人婴儿中有160例（7.4%）达到阈值ROP（定义为在存在“plus病”[后极部血管扩张和迂曲]的情况下，1区或2区至少有5个连续或8个累计钟点的3期视网膜病变），但1584例黑人婴儿中只有51例（3.2%）进展为阈值ROP。使用多因素逻辑回归分析，即使考虑出生体重、分娩时的孕周状态、性别、多胎妊娠和转运状态，种族仍是阈值疾病发生的一个高度显著因素（P <.001）。
低出生体重白人婴儿中严重的、威胁视力的ROP发生率高于看似风险相当的低出生体重黑人婴儿。这种差异的原因尚不清楚。我们推测视网膜色素沉着的差异可能使黑人婴儿相对免受自由基介导的光毒性损伤。
