Zone of retinal vascularization and refractive error in premature eyes with and without spontaneously regressed retinopathy of prematurity
Zone of retinal vascularization and refractive error in premature eyes with and without spontaneously regressed retinopathy of prematurity
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DOI：
10.1016/j.jaapos.2019.03.006
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发表时间：
2019-08-01
期刊：
影响因子：
1.6
通讯作者：
Kassem, Iris S.
中科院分区：
文献类型：
--
作者：
Dikopf, Mark S.;Machen, Lindsay A.;Kassem, Iris S.
目的评价无早产儿视网膜病变（ROP）或ROP自发消退的早产儿视网膜血管化区与屈光不正的关系。方法回顾性分析2009年至2015年在一家三级学术中心筛查ROP的新生儿病历。病例包括未经治疗的自发性视网膜病变消退的眼睛;未诊断为视网膜病变的早产儿眼睛为对照组。主要结果是视网膜血管化区和屈光不正，通过睫状肌麻痹视网膜检影检查（CR）确定。结果在378只评估的眼睛中，184只有ROP，其中24只接受治疗并被排除。首次CR时的平均校正年龄为7.5个月。17只无ROP的眼睛在第一次CR时近视（8.8%），相比之下，35只ROP消退的眼睛（21.9%）。未接受治疗的眼睛在I区没有血管停止;值得注意的是，44%的自发消退的II区眼睛是近视。无论ROP状态如何，CR在血管化区域之间存在显著差异（P < 0.001），血管化后停止的近视发生率更高。对于所有患眼，完全血管化与II区（P < 0.0001）和III区与II区（P = 0.001）之间的CR存在显著差异; III区与完全血管化之间无统计学差异（P = 0.15）。未治疗、自发性视网膜病变消退眼的近视屈光度与新生儿视网膜病变程度的关系也是如此（P <0.01，P = 0.01，P = 0.8343）。II区血管生长停止的患者应密切监测近视和屈光性弱视。
PURPOSE To evaluate the relationship between zone of retinal vascularization and refractive error in premature infants without retinopathy of prematurity (ROP) or with spontaneously regressed ROP.METHODS The medical records of neonates screened for ROP between 2009 and 2015 at a tertiary academic center were reviewed retrospectively. Cases included untreated eyes with spontaneously regressed ROP; premature eyes without a diagnosis of ROP were control subjects. Primary outcomes were zone of retinal vascularization and refractive error, determined by cycloplegic retinoscopy (CR).RESULTS Of 378 eyes evaluated, 184 had ROP, 24 of which underwent treatment and were excluded. Mean corrected age at first CR was 7.5 months. Seventeen eyes without ROP were myopic at first CR (8.8%), compared to 35 eyes with regressed ROP (21.9%). No untreated eyes had halted vasculature in zone I; notably, 44% of spontaneously regressed zone II eyes were myopic. Irrespective of ROP status, CR significantly differed by zone of vascularization (P < 0.001), with more myopia occurring with posterior halting of vascularization. For all eyes, CR significantly differed between complete vascularization versus zone II (P < 0.0001) and zone III versus zone II (P = 0.001); zone III versus complete vascularization did not statistically differ (P = 0.15). This relationship held true for untreated, spontaneously regressed ROP eyes (P < 0.01, P = 0.01, P = 0.8343).CONCLUSIONS More myopic refraction occurred in neonates screened for ROP with posterior halting of vascularization. Patients with halted vascular growth in zone II should be closely monitored for myopia and refractive amblyopia.