Analysis On High Risk Factors Of Retinopathy Of Prematurity And Study Of Fundus Retinal And Choroidal Thickness In Premature Children

Objective:Exploring the risk factors for the development of retinopathy(ROP)in preterm infants;Optical coherence tomography(OCTA)was used to detect the structure of the macular retina and choroid in children with a history of preterm birth,and to explore the differences in retinal thickness(RT)and choroidal thickness(CT)between preterm and term children.Methods:A total of 644 premature infants who met the inclusion criteria were collected and analyzed from January 1,2010 to January 31,2022 in the Department of Neonatology and Ophthalmology of the Second Affiliated Hospital of Nanchang University.All subjects collected general data,performed baseline analysis,and used XGBoost,Random Forest(RF),Gaussian NB(GNB)and other methods to sort the importance of the variables after preliminary screening,and took the variables common to the variable set of the three methods,and screened and sorted the risk factors for ROP development.At the same time,from April 2021 to January 2022,some children with a history of preterm birth who met the inclusion criteria were selected,and the full-term children of the same age were used as the control group,The CT of the subfoveal of the macula was measured using the OCTA scanning mode of 3mm*3mm,and the ETDRS partitioning mode was scanned for the retina of the macula,observe the RT of different areas of the macula.Results:1 、 Apgar score(1 min at Born),time of ROP treatment,blood transfusion,gestational age and neonatal hyperglycemia were high risk factors the development of ROP in newborn preterm infants;2 、 There was no significant difference in the incidence of ROP between singletons and twins,but there was significant difference in the incidence of severe cases of ROP between singletons and twins(P < 0.05).There were significant differences in Apgar score(Birth 1min)< 7,blood transfusion,gestational age and neonatal hyperglycemia between premature and full-term infants(P < 0.05);3、RT、CT:There was no significant difference in macular RT between the preterm children group and the control group in macular fovea,inner ring and outer ring(P > 0.05).There was no significant difference in subfoveal CT between the preterm children group and the control group(P > 0.05);4 、 Correlation between RT,CT and best corrected visual acuity(BCVA),equivalent lens(SE),axial length(AL):In the preterm children group,RT in the nasal inner ring,the upper inner ring,the temporal inner ring and the nasal outer ring were negatively correlated with BCVA(P < 0.05).The RT of macula fovea of the preterm children group was negatively correlated with AL(P < 0.05).There was no significant correlation between SE and retinal region RT in the preterm children group(P > 0.05).There was no significant correlation between subfoveal CT and BCVA,SE and AL in preterm children group(P > 0.05).Conclusions:1.Apgar score(1 min at Born),blood transfusion,gestational age and neonatal hyperglycemia are the high risk factors for ROP in newborn preterm infants,which may be clinically important in assessing the occurrence and severity of retinopathy of prematurity;2.In non-ROP or ROP stage 1-2 preterm children with a history of preterm birth,the later macular RT and subfovea CT are similar to those of term children;3.There is a correlation between BCVA and retinal thickness in preterm children with a history of preterm birth,and the macular retinal thickness will gradually become thinner with the increase of axial length.