Reynolds J D, Hardy R J, Kennedy K A, Spencer R, van Heuven W A, Fielder A R
State University of New York at Buffalo, USA.
N Engl J Med. 1998 May 28;338(22):1572-6. doi: 10.1056/NEJM199805283382202.
Hospital-nursery lighting has been suggested as a factor in causing retinopathy of prematurity. Despite ongoing debate, a causal relation has not been established.
We conducted a prospective, randomized, multicenter study of the effects of light reduction on 409 premature infants with birth weights of less than 1251 g and gestational ages of less than 31 weeks. Two hundred five infants were exposed to reduced light, and 204 to typical nursery lighting. The amount of light reaching the infants' eyes was reduced within 24 hours after birth by placing goggles on the infants that reduced visible-light exposure by 97 percent and ultraviolet-light exposure by 100 percent. The babies wore the goggles until 31 weeks' postconceptional age or 4 weeks after birth, whichever was longer. Once the goggles were removed, ophthalmologists masked to the treatment assignments assessed the infants for retinopathy of prematurity at least biweekly for up to 13 weeks.
There were 188 infants in the group that wore goggles and 173 in the control group who survived and were available for follow-up. The mean birth weights were 906 g in the goggles group and 914 g in the control group; the mean gestational ages were 27.4 weeks and 27.2 weeks, respectively. The mean ambient-light level adjacent to the infants' faces was 399 lux for the goggles group and 447 lux for the control group. Retinopathy of prematurity was diagnosed in 102 infants (54 percent) in the goggles group and 100 (58 percent) in the control group (relative risk, 0.9; 95 percent confidence interval, 0.8 to 1.1; P=0.50).
A reduction in ambient-light exposure does not alter the incidence of retinopathy of prematurity.
医院育婴室照明被认为是导致早产儿视网膜病变的一个因素。尽管争论仍在继续，但因果关系尚未确立。
我们对409名出生体重低于1251克、胎龄小于31周的早产儿进行了一项前瞻性、随机、多中心研究，以探讨减少光照的影响。205名婴儿暴露于减少的光照下，204名婴儿暴露于典型的育婴室照明下。通过给婴儿戴上护目镜，在出生后24小时内将到达婴儿眼睛的光量减少，该护目镜可将可见光暴露减少97%，紫外线暴露减少100%。婴儿佩戴护目镜直至孕龄31周或出生后4周，以较长者为准。一旦取下护目镜，对治疗分组不知情 的眼科医生至少每两周对婴儿进行一次早产儿视网膜病变评估，最长评估13周。
佩戴护目镜组有188名婴儿存活并可进行随访，对照组有173名。护目镜组的平均出生体重为906克，对照组为914克；平均胎龄分别为27.4周和27.2周。护目镜组婴儿面部附近的平均环境光水平为399勒克斯，对照组为447勒克斯。护目镜组有102名婴儿（54%）被诊断为早产儿视网膜病变，对照组有100名（58%）（相对风险，0.9；95%置信区间，0.8至l.l；P=0.50）。
环境光暴露的减少不会改变早产儿视网膜病变的发生率。
