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瑞典五年视网膜病变治疗分析:SWEDROP结果分析

Holmstrm G, Hellstrm A, Jakobsson P, et al.

期刊名称:British Journal of Ophthalmology

卷期:2016年第100卷第12期

摘要

背景/ 目的:早产儿视网膜病变(ROP)是一种威胁视力的疾病,需要有效的筛查和治疗。本研究旨在描述瑞典ROP治疗的各个方面。方法:选取瑞典国家早产儿视网膜病变国家登记册,一个基于网络的国家登记册中2008 - 2012年出生的婴儿的ROP治疗数据。结果: 2008-2012年,瑞典3488名出生时胎龄<31周的婴儿进行了ROP筛查。共有30.3%(1057/3488)的婴儿出现ROP5.2%(181/3488)的婴儿接受了治疗。83.2%(149/179)的治疗婴儿中,至少有一只眼为1ROP。三分之一的眼(32.2%右,29.9%左)不止一次治疗。激光是90%的眼唯一的治疗方式。右眼和左眼首次激光治疗的激光斑点平均数量分别是1177次和1386次。出生时激光点数与GA呈负相关(p = 0.01)。在5年期间,治疗频率或激光斑点数量没有变化。在进行抗血管内皮生长因子注射治疗的28只眼中,5只眼中使用环扎带,7只眼进行玻璃体切除术。结论:本研究显示,5年研究期间ROP的发生率和治疗频率类似。许多外科医生参与了数量相当有限的婴儿的治疗。结果呼吁就ROP的治疗进行国家讨论。

BACKGROUND/AIMS:Retinopathy of prematurity (ROP) is a sight-threatening disease, requiring efficient screening and treatment. The present study aims to describe various aspects on treatment for ROP in Sweden.METHODS:Data on treatment for ROP in infants born in 2008-2012 were extracted from Swedish national register for retinopathy of prematurity, a web-based national register.RESULTS:During 2008-2012, 3488 infants with a gestational age (GA) at birth of <31weeks had been screened for ROP in Sweden. Altogether, 30.3% (1057/3488) of the infants developed ROP and 5.2% (181/3488) were treated. Type 1 ROP was found in at least one eye in 83.2% (149/179) of the treated infants. One third of the eyes (32.2% right, 29.9% left eyes) were treated more than once. Laser was the only treatment in 90% of the eyes. Mean number of laser spots at first laser session was 1177 and 1386 in right and left eyes, respectively. Number of laser spots correlated negatively with GA at birth (p=0.01). There was no change in frequency of treatment or number of laser spots during the 5-year period. Anti-vascular endothelial growth factor injections were performed in 28 eyes, encircling band was used in five eyes and vitrectomies were performed in seven eyes. Twenty-six retinal surgeons performed 9.4 (range 1-37) treatment sessions in the 181 infants.CONCLUSIONS:The present study reveals similar incidences of ROP and frequencies of treatment during the 5-year study period. Many surgeons were involved in treatment of a rather limited number of infants. The results call for national discussions on organisation of ROP treatment.


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