retinopathy of prematurity

早产儿视网膜病变
  • 文章类型: Journal Article
    The UK screening and treatment of retinopathy of prematurity (ROP) updated 2022 guidelines were developed by a multidisciplinary guideline development group from the Royal College of Paediatrics and Child Health and the Royal College of Ophthalmologists, following the standards of the National Institute for Health and Care Excellence. They were published on the websites of the Royal College of Paediatrics and Child Health and the Royal College of Ophthalmologists in March 2022, and formally published in Early Human Development in March 2023. The guidelines provide evidence-based recommendations for the screening and treatment of ROP. The most significant change in the 2022 updated version compared to the previous guidelines is the lowering of the gestational age screening criterion to below 31 weeks. The treatment section covers treatment indications, timing, methods, and follow-up visits of ROP. This article interprets the guidelines and compares them with ROP guidelines/consensus in China, providing a reference for domestic peers.
    英国早产儿视网膜病变的筛查和治疗指南2022更新版由英国皇家儿科与儿童健康学院和皇家眼科学院的多学科指南制订小组按照英国国家卫生与临床优化研究所标准制订,于2022年3月发表在英国皇家儿科与儿童健康学院网站和皇家眼科学院网站,2023年3月在Early Human Development杂志正式发表。该指南对早产儿视网膜病变的筛查及治疗进行了循证推荐和建议。与更新前的指南相比,2022更新版最重要的变化是将胎龄筛查标准降至31周以下;治疗部分涵盖了早产儿视网膜病变的治疗适应证、时间、方法及随诊。该文对该指南进行解读并与国内早产儿视网膜病变指南/共识进行比较,为国内同行提供参考和借鉴。.
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  • 文章类型: Journal Article
    中华医学会儿科学分会新生儿学组和中华儿科杂志编辑委员会组织多学科专家,依据我国高危新生儿眼病筛查管理现状与存在问题,共同制订“高危新生儿眼病筛查分类分级管理专家共识(2024)”,总结高危新生儿眼病筛查规范管理5个共性问题以及11条专家推荐建议,强调对高危新生儿眼病的高危因素分类识别和眼病筛查管理服务的分级标准化建设,明确高危新生儿眼病筛查的管理方向。.
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  • 文章类型: Journal Article
    早产儿视网膜病变(ROP)在全球范围内显着导致儿童失明。由于新生儿护理的改善以及ROP筛查和治疗设施的不足,低收入和中等收入国家(LMICs)的负担不成比例。这项研究旨在验证在巴基斯坦三级护理机构中出现的早产儿队列中的出生后生长和早产儿视网膜病变(G-ROP)筛查标准的性能。这项横断面研究利用阿加汗大学医院新生儿重症监护病房(NICU)收治的新生儿的回顾性图表回顾,巴基斯坦从2018年1月到2022年2月。完整的G-ROP标准被用作1型ROP婴儿的预测工具,2型ROP,没有ROP结果。在166个案例中,125例纳入最终分析,其余病例因数据不完整而被排除.83名婴儿(66.4%)出现任何阶段的ROP,其中55人(44%)发展为1型ROP,28(22.4%)开发的2型ROP,19例(15.2%)接受ROP治疗。中位体重为1060gm(IQR=910至1240gm),中位胎龄为29wk(IQR=27至30wk)。G-ROP标准显示对1型ROP触发警报的敏感度为98.18%(95%CI:90.28-99.95%)。G-ROP标准对2型ROP达到100%的灵敏度(95%CI:87.66-100%)。G-ROP标准触发任何类型ROP警报的总体灵敏度为98.8%(95%CI:93.47-99.97%)。因此,G-ROP筛查模型在巴基斯坦三级护理环境中检测ROP高危婴儿非常敏感,支持其在标准筛选标准可能不够的LMIC中的使用。
    Retinopathy of Prematurity (ROP) significantly contributes to childhood blindness globally, with a disproportionately high burden in low- and middle-income countries (LMICs) due to improved neonatal care alongside inadequate ROP screening and treatment facilities. This study aims to validate the performance of Postnatal Growth and Retinopathy of Prematurity (G-ROP) screening criteria in a cohort of premature infants presenting at a tertiary care setting in Pakistan. This cross-sectional study utilized retrospective chart review of neonates admitted to the neonatal intensive care unit (NICU) at The Aga Khan University Hospital, Pakistan from January 2018 to February 2022. The complete G-ROP criteria were applied as prediction tool for infants with type 1 ROP, type 2 ROP, and no ROP outcomes. Out of the 166 cases, 125 cases were included in the final analysis, and remaining cases were excluded due to incomplete data. ROP of any stage developed in 83 infants (66.4%), of whom 55 (44%) developed type 1 ROP, 28 (22.4%) developed type 2 ROP, and 19 (15.2%) were treated for ROP. The median BW was 1060 gm (IQR = 910 to 1240 gm) and the median gestational age was 29 wk (IQR = 27 to 30 wk). The G-ROP criteria demonstrated a sensitivity of 98.18% (95% CI: 90.28-99.95%) for triggering an alarm for type 1 ROP. The G-ROP criteria achieved 100% sensitivity (95% CI: 87.66 to 100%) for type 2 ROP. The overall sensitivity of G-ROP criteria to trigger an alarm for any type of ROP was 98.8% (95% CI: 93.47 to 99.97%). Thus, the G-ROP screening model is highly sensitive in detecting at-risk infants for ROP in a Pakistani tertiary care setting, supporting its use in LMICs where standard screening criteria may not suffice.
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  • 文章类型: Letter
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  • 文章类型: Practice Guideline
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  • 文章类型: Journal Article
    未经证实:在发展中国家,早产儿视网膜病变(ROP)的发病率正在增加,包括埃及。二级预防需要通过制定区域筛查指南来及时发现,在此之前,应该进行大规模研究,以描述处于危险中的人群。
    未经批准:预期,多中心探索性研究,包括埃及城市环境中的五所大型高等教育机构。对所有胎龄(GA)<37周和/或出生体重(BW)≤2000克的婴儿进行筛查。还包括临床病程不稳定的更成熟和更重的婴儿。主要结果指标是ROP率和高危疾病发生率与潜在危险因素的关系。
    未经评估:在768只眼睛(384只经过筛查的婴儿)中,347眼(45.2%)有1期或以上疾病,43眼(5.6%)有高危疾病。具有1期或更高ROP和需要治疗的ROP的眼睛平均(±SD)GA为33.4(±2.6)周和32.8(±3.2)周,BW为1842.3(±570.1)克和1747.6±(676.2)克,分别。需要治疗的眼睛属于与不需要治疗的眼睛相比具有显著更低的GA和显著更高的合并症患病率的婴儿。
    UNASSIGNED:在埃及城市环境中,ROP和高风险疾病的发病率与其他地方和当地的可比环境中的发病率相似。这项探索性研究支持为ROP定制当地筛查标准,并可能有助于国家指导方针的未来发展。
    UNASSIGNED: Retinopathy of prematurity (ROP) is increasing in incidence in developing nations, including Egypt. Secondary prevention requires timely detection through the development of regional screening guidelines, which should be preceded by large-scale studies to characterize the population at risk.
    UNASSIGNED: A prospective, multicentric exploratory study that included five large tertiary institutions in an urban Egyptian setting. All infants born with gestational age (GA) < 37 weeks and/or birth weight (BW) ≤ 2000 grams were screened. More mature and heavier infants with unstable clinical course were also included. The primary outcome measure was the rate of ROP and high-risk disease occurrence in relation to underlying risk factors.
    UNASSIGNED: Of the 768 eyes (384 screened infants), 347 eyes (45.2%) had stage 1 or higher disease, and 43 eyes (5.6%) had high-risk disease. Eyes with stage 1 or higher ROP and treatment-requiring ROP had a mean (± SD) GA of 33.4 (± 2.6) weeks and 32.8 (± 3.2) weeks, and BW of 1842.3 (± 570.1) grams and 1747.6 ± (676.2) grams, respectively. Treatment-requiring eyes belonged to infants that had significantly lower GA and significantly higher prevalence of co-morbidities than non-treatment-requiring eyes.
    UNASSIGNED: The incidence of ROP and high-risk disease in an urban Egyptian setting are similar to those in comparable settings elsewhere and locally. This exploratory study supports tailoring local screening criteria for ROP, and may aid the future development of national guidelines.
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  • 文章类型: Journal Article
    由于早产儿视网膜病变(ROP)的特点各异,取决于他们接受的新生儿护理的质量,ROP的通用筛选标准是不可能的。这项研究的目的是比较那些计划制定指南的ROP指南,特别是在资源贫乏的环境中。对PubMed进行了系统审查,Embase和准则登记册,以确定国家或国际政策声明或英文准则,2010-2021年发行或运营。还审查了两个出版物的参考书目。搜索确定了633、1081和317条记录,分别,并从其他来源检索了157条记录。分析中包括23种出版物。大多数文件包括定义为<32周胎龄(GA)或≤1500g出生体重(BW)的筛选截止值。最高值在菲律宾(<35周GA;<2000g)和印度(≤34周GA;<2000g)。最低的是高收入国家,即美利坚合众国(GA≤32周)和新西兰(BW<1250g)。大多数指南包括需要考虑的其他风险因素。筛查何时开始的最常见指标是GA和实际年龄的组合。除一个文件外,所有文件都定义了筛选可以停止的时间。就这些迹象达成了普遍共识,治疗的时机和方法。不同国家抗VEGF治疗的适应症各不相同。为少数低收入国家确定了准则。筛查适应症的变化反映了不同环境下对风险因素的不同暴露。
    As the characteristics of preterm infants with retinopathy of prematurity (ROP) vary, depending on the quality of neonatal care they received, universal screening criteria for ROP are not possible. The purpose of this study was to compare ROP guidelines for those planning to develop guidelines, particularly in resource-poor settings.A systematic review was undertaken of PubMed, Embase and guidelines registers to identify national or international policy statements or guidelines in English, issued or operational in 2010-2021. Bibliographies of two publications were also reviewed. The searches identified 633, 1081 and 317 records, respectively, and 157 records were retrieved from other sources. 23 publications were included in the analysis.Most included documents defined cut-offs for screening as <32 weeks gestational age (GA) or ≤1500g birth weight (BW). The highest values were in the Philippines (<35 weeks GA; <2000g) and India (≤34 weeks GA; <2000g). The lowest were in high-income countries, i.e. the United States of America (≤32 weeks for GA) and New Zealand (<1250g for BW). Most guidelines included additional risk factors to consider. The most frequent indication for when screening should start was a combination of GA and chronological age. All but one document defined when screening could stop. There was general consensus on the indications, timing and methods of treatment. Indications for anti-VEGF therapy varied between countries.Guidelines were identified for a limited number of countries with none from low-income settings. Variation in the indications for screening reflects the varying exposure to risk factors in different settings.
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  • 文章类型: Journal Article
    评估城市III级新生儿重症监护病房(NICU)早产儿视网膜病变(ROP)的临床特征和筛查指南。
    :根据国家筛查指南,2018年1月至2020年12月,在城市III级NICU中,对出生体重≤2000克或胎龄<34周的婴儿进行了ROP前瞻性筛查。标准指南用于ROP分类和治疗。
    总共,211名婴儿完成筛查;46名(21.8%)婴儿发生ROP,13名(6.2%)患有1型(可激光治疗)ROP。在46名患有ROP的婴儿中,44例(95.65%)患有2区疾病,2例(4.34%)患有1区疾病。在102名出生体重≤1500克的婴儿中,ROP和1型ROP的发生率分别为41.18%和11.76%,分别。在109名出生体重>1500克的婴儿中,4名(3.67%)发生ROP,1名(0.91%)婴儿(外胎)需要治疗。
    在III级城市NICU中,大多数发生ROP的婴儿出生体重≤1500克。1区ROP并不常见。重婴儿(>1500克出生体重)的ROP发生率较低,在极少数情况下需要治疗。在城市NICU,ROP筛查和治疗的负担转移到小体重儿和低出生体重儿身上.
    To evaluate the clinical profile and screening guidelines of retinopathy of prematurity (ROP) in an urban level III neonatal intensive care unit (NICU).
    : Infants with ≤2000-gm birth weight or <34 weeks gestational age were prospectively screened for ROP in an urban level III NICU between January 2018 and December 2020, based on national screening guidelines. Standard guidelines were used for ROP classification and treatment.
    In total, 211 infants completed screening; 46 (21.8%) infants developed ROP and 13 (6.2%) had type 1 (laser treatable) ROP. Of the 46 infants with ROP, 44 (95.65%) had zone 2 and two (4.34%) had zone 1 disease. In the 102 infants with ≤1500-gm birth weight, the incidence of ROP and type 1 ROP were 41.18% and 11.76%, respectively. Out of the 109 infants with >1500-gm birth weight, four (3.67%) developed ROP and one (0.91%) infant (an outborn) required treatment.
    The majority of infants developing ROP in a level III urban NICU had ≤1500-gm birth weight. Zone 1 ROP was uncommon. Incidence of ROP in heavier infants (>1500-gm birth weight) was low, and treatment was required in a rare instance. In an urban NICU, the burden of ROP screening and treatments shifts to small and low-birth-weight infants.
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