Retinopathy of Prematurity in a Rural Neonatal Intensive Care Unit in South India-A Prospective Study
Retinopathy of Prematurity in a Rural Neonatal Intensive Care Unit in South India-A Prospective Study
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DOI：
10.1007/s12098-012-0707-y
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发表时间：
2012-07-01
影响因子：
4.3
通讯作者：
Shetty, Bhujang
中科院分区：
文献类型：
--
作者：
Hungi, Bhavana;Vinekar, Anand;Shetty, Bhujang
报告农村新生儿早产儿视网膜病变（ROP）的发病率、频谱及治疗结果。这项前瞻性、观察性、非随机研究在印度南部地区总部的三级新生儿重症监护病房（NICU）进行。118名出生体重为千分之一货币符号2000 g和/或妊娠期（POG）为千分之一货币符号34周的婴儿被纳入研究。通过间接检眼镜和宽视场数字成像（Retcam）对符合条件的婴儿进行筛查，直到视网膜血管化完成或疾病消退。采用激光治疗早产儿视网膜病变（ETROP）。ROP的总发生率为41.5%，可治ROP为26.4%(24/91)，可治ROP为10.2%（24/236）。有ROP和没有ROP的平均出生体重和妊娠期分别为1555.9和1672.5 g （P 0.005）和32.2和34.6周（P < 0.001）。一半的治疗眼在第1区有侵略性的后ROP。所有治疗过的眼睛都有良好的结果。呼吸窘迫综合征、氧疗、新生儿黄疸和脓毒症在ROP组较高，但无统计学意义。在所有接受筛查的婴儿中，68名（57.6%）的体重和年龄超过了美国筛查的临界值。其中36.8%有一定的ROP， 8%需要治疗。这是印度地区新生儿重症监护室的第一个前瞻性ROP研究，并与先前发表的城市数据进行了比较。如果在农村地区使用西方筛查指南，我们可能会有很大比例的婴儿被遗漏，而这些婴儿可能需要治疗。
To report the incidence, spectrum and treatment outcome of Retinopathy of Prematurity (ROP) in a rural neonatal nursery.This Prospective, observational, non-randomized study was conducted in a level III Neonatal Intensive Care Unit (NICU) at district headquarters in South India. 118 babies with birth weight a parts per thousand currency sign2000 g and/or period of gestation (POG) a parts per thousand currency sign34 wk were included in the study. Eligible infants were screened with indirect ophthalmoscopy and wide-field digital imaging (Retcam) until retinal vascularization was complete or disease regressed. Early Treatment Retinopathy of Prematurity (ETROP) guidelines were followed for laser.The overall incidence of ROP was 41.5% and treatable ROP was 26.4% (24/91) of eyes diagnosed with ROP and 10.2% (24/236) of the overall eyes screened. The mean birth weights and periods of gestation with and without ROP were 1555.9 vs. 1672.5 g (P 0.005) and 32.2 vs. 34.6 wk, respectively (P < 0.001). Half of the treated eyes had aggressive posterior ROP in Zone 1. All treated eyes had a favorable outcome. Respiratory distress syndrome, oxygen therapy, neonatal Jaundice and sepsis were higher in the ROP group but was not statistically significant. Of the overall infants screened, 68 (57.6%) were heavier and older than the American screening cut-off. Of these, 36.8% had some stage ROP and 8% required treatment.This is the first prospective ROP study from a district NICU in India and compares with previously published urban data. If Western-screening guidelines are used in the rural scenario, we risk a significant proportion of infants being missed who may require treatment.