| Objective:To analysis the incidence of retinopathy of prematurity(ROP)in the ocular fundus screening of ophthalmology in our hospital,to investigate the correlation between the factors which induce retinopathy and the incidence of retinopathy in premature infants,and to observe the short-term efficacy and safety for the anti-VEGF treatment of early retinopathy of prematurity,in order to provide the referce for the clinical prevention and treatment of ROP.Methods:150 cases(300 eyes)of preterm children who completed the fundus screening from June 2015 to December 2016 in the First Affiliated Hospital of Dalian Medical University were studied.In the case of full mydriasis,the fundus examination were completed by the same fundus disease expert with wealth of clinical experience,using of binocular indirect ophthalmoscope and diopter 20D lens,if necessary,with the help of scleral pressure to help the surrounding retinal examination.The 14 factors,such as:gestational age,birth weight,gender,blood infusion,test-tube baby,oxygen support,application of mechanical ventilation,natural labour or cesarean sectionischemia and hypoxic encephalopathy,neonatal hyaline membrane disease,pneumonia,ARDS were detailed recorded.According to the results of fundus screening were divided into two groups:non ROP group and ROP group,and the two groups between the 14 factors for statistical analysis.Five patients(10 eyes)with preterm infants with pre-threshold ROP and 7 patients(14 eyes)with threshold ROP were treated with vitreous cavity injection ranibizumab(0.25mg).The patients were followed up for 3 months,to observe the outcome of fundus lesions and complications.Result:(1)Of the 150 cases(300 eyes)of the preterm children who completed the screening,26 cases(52 eyes)suffered from ROP and the prevalence rate was 17.3%.The first,second,third,fourth,fifth stage of ROP was 34.6%(9/26)?27.0%(7/26)?30.8%(8/26)?3.8%(1/26)?3.8%(1/26).And 12 cases(24 eyes)were given vitreous cavity injection of ranibizumab(0.25mg).13cases(26 eyes)lesions subsided.(2)The 14 factors between the ROP group and the non ROP group were analyzed by two-dimensional crosstable analysis.The results showed thatp value of the gestational age,birth weight,oxygen intake,fetal number,blood transfusion are less than 0.05,the difference is statistically significant,The p value of remaining factors:gender,test-tube baby,production,ischemia and hypoxic encephalopathy,neonatal hyaline membrane disease,pneumonia,ARDS are greater than 0.05,the difference was not statistically significant.The multivariate logistic regression equation was established,and the five factors of birth gestational age,birth weight,oxygen intake,blood transfusion and ventilator were observed,show that p<0.05 and the wals value was larger,the p value of the number of fetuses was less than 0.05,but the wals was smaller.the difference was satistical significance,the remaining factors p>0.05,no statistically significant.(3)During the 12 cases(24 eyes)preterm infants with vitreous cavity injected with leazuzumab(0.25 mg),they are 5(10 eyes)of the threshold ROP,7(14 eyes)of the pre-threshold ROP.The monocular disease of 1 case of threshold ROP preterm children was relapsed after one month of surgery,and the remaining 11 cases(22 eyes)after a single eye injection follow-up observation for 3 months,lesions subsided,retinal complete vascularization,no signs of recurrence,1 case(1 eye)1 day after the discovery of subconjunctival hemorrhage,and absorption after one week,no infection,corneal injury,increased intraocular pressure,endophthalmitis and other surgical complications were appeared.Conclusion:(1)The incidence of ROP in the screening of premature infants in our hospital was 17.3%.(2)Birth gestational age,birth weight,oxygen,fetal number,blood transfusion,the use of ventilator are associated with the occurrence of retinopathy of prematurity.(3)The short-term efficacy of intravitreal injection of ranibizumab treat pre-threshold ROP and threshold ROP,is significant and safe. |
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