| Objective: To investigate the incidence and risk factors of retinopathy of prematurity(ROP)in the First Affiliated Hospital of Dalian Medical University and to observe the efficacy of anti-VEGF treatment on ROP.Methods:(1)A retrospective analysis of 250 eyes of 125 preterm infants who were screened at our hospital from January 2017 to January 2018 and the final preterm infants included in the study are 206 eyes of 103 eyes.Inclusion criteria: gestational age at birth <34 weeks and birth weight <2200g;the refraction transparent is clear enough to observe retinopathy;medical information recorded in detail and reliable.The informations of preterm children are recorded in detail including sex,gestational age at birth,birth weight,oxygen and other 21 factors and the mother’ s history of pregnancy such as pregnancy-induced hypertension,premature rupture of fetal membranes and other 5 factors.The incidence of ROP was calculated according to the screening results.Univariate analysis and multivariate logistic regression analysis were performed on ROP and non-ROP groups to explore the risk factors of ROP.(2)Intravitreal injection of anti-VEGF on type 1 of pre-threshold and threshold ROP.The same experienced ophthalmologist aims the 1.5mm angle after the scleral limbus perpendicular to the surface of the eye to finish intravitreal injection(ranibizumab 0.025ml).Postoperative observation should be made on disease outcome and whether the ocular and systemic adverse reactions.Results:(1)The incidence of ROP: A total of 125 preterm infants were examined in our hospital,and ROP was diagnosed in 31 cases(62 eyes),the incidence rate was 24.8%.The proportion of stage 1,2 and 3 is 45.2%(14/31),29.0%(9/31),25.8%(8/31)respectively,without stage 4 and 5 of ROP.(2)Analysis of risk factors of ROP: 103 cases(206 eyes)were included in the study except the missing follow-up and incomplete records of medical history ones.Based on the results of diagnosis,preterm infants were divided into ROP group and non-ROP group.Univariate analysis of gestational age,birth weight,oxygen intake,blood transfusion and other factors were carried out between the two groups.The results showed that gestational age,birth weight,ventilator,intrauterine infection of mother and placental abruption,blood transfusion p value of <0.05,the difference was statistically significant,indicating that these factors are risk factors for ROP.Multivariate logistic regression analysis of selected ROP risk factors shows that p value of gestational age,birth weight and oxygen is <0.05,the difference was statistically significant,indicating that these factors are independent risk factors for ROP.Preterm infants were divided into three groups according to their gestational age as≤28 weeks,28 ~ 31 weeks,> 31 weeks,and the incidence of ROP were 68.8%,29.5%,7.7% respectively.p values were<0.05 and the difference was statistically significant,indicating that the smaller the gestational age,the higher the incidence of ROP;the birth weight was divided into three groups by 1000 g,1000 ~ 1500 g,> 1500 g,and the incidence of ROP in each group were 59.3% 28.9% and 10.5%,respectively.The p values were less than 0.05 and the difference was statistically significant,indicating that the smaller the birth weight,the higher the incidence of ROP.(3)Anti-VEGF treatment of ROP: According to the screening results,among 8 eyes(16 eyes)of threshold and type1 pre-threshold ROP,1 eyes(2 eyes)refused to be treated in our hospital.Among seven eyes(14 eyes),6 cases of 11 cases got the condition improved after single intravitreal injection without recurrence and deterioration were found.The cure rate was 78.6%.One case had subconjunctival hemorrhage on the first day after operation and the subconjunctival hemorrhage disappeared one week after the operation.No significant improvement was observed in 2 cases of 3 eyes one month after operation.These patients were treated with intravitreal injection of ranibizumab once again in our hospital.No recurrence and no signs of progression were observed when follow-up.Adverse reactions were not found during follow-up.Conclusions:(1)The incidence of retinopathy of prematurity in XX is relatively high(24.8%).Birth weight,birth weight and oxygen inhalation are independent risk factors of ROP.And the gestational age,birth weight and ROP are negatively correlated.(2)Intravitreal injection of anti-VEGF drugs(ranibizumab)was effective in the treatment of threshold and type 1 pre-threshold ROP.No serious ocular and systemic adverse reactions were found during follow-up time indicating the safe outcome. |
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