摘要
目的 观察激光光凝治疗对早产儿视网膜病变（ROP）患眼视野及屈光状态的影响.方法 回顾性病例研究.曾接受激光光凝治疗的ROP患儿39例73只眼（ROP组）和年龄、性别匹配的正常儿童13名25只眼（正常对照组）纳入研究.ROP组患儿中,男性24例45只眼,女性1 5例28只眼.平均年龄（7.00±128）岁.首次接受激光光凝治疗时平均矫正胎龄（PA） （38.74±3.82）周,平均出生体重（BW）（140233±369.61）g,平均激光光斑数量（517.86±277.40）个.正常对照组13名受检儿童中,男性6例12只眼,女性7例13只眼;平均年龄（7.17±0.96）岁;均为足月产儿.两组受检儿童平均年龄（t=0.691）、性别构成比（x2=1.425）比较,差异无统计学意义（P=0.491、0.233）.均行最佳矫正视力（BCVA）、裂隙灯显微镜、间接检眼镜、屈光、视野检查.对比观察两组受检儿童视野平均缺损（MD）值、等效球镜（SE）的变化.根据视野检查结果,ROP组患儿分为有无视野缺损组和轻度、中重度视野缺损组,比较两组之间胎龄（GA）、PA、BW、光斑数量、SE的差异.结果 正常对照组、ROP组受检眼视野MD值分别为（1.27±3.34）、（4.87±5.12） dB;两组受检眼之间视野MD值比较,差异有统计学意义（t=-4.01,P＜0.001）.有无视野缺损组患眼之间BW、光斑数量、SE比较,差异有统计学意义（t=2.074、-1.996、-2.162,P=0.042、0.026、0.034）;GA比较,差异无统计学意义（t=1.973,P=0.052）.轻度视野缺损组与中重度视野缺损组之间SE比较,差异有统计学意义（t=3.283,P=0.002）;PA比较,差异无统计学意义（t=2.03,P=0.051）.SE≤-0.25 D者12只眼,占18.8％.ROP组、正常对照组受检眼之间SE比较,差异无统计学意义（t=-1.312,P=0.193）.单因素分析结果显示,ROP组患儿BW、病变分期与SE呈显著相关（r=-0.304、-0.387,P=0.015、0.002）.ROP组患眼平均BCVA为0.84±0.23.其中,≥0.5者59只眼,占91.2％.结论 激光光凝治疗对ROP患眼视野、屈光影响较小;视力预后较好.
Objective To observe visual field outcome and refractive status of patients with retinopathy of prematurity （ROP） treated by laser photocoagulation.Method The data of 39 ROP patients （73 eyes） who received laser photocoagulation were retrospectively analyzed and compared with 13 normal control subjects （25 eyes） whose age and sex were matched with ROP group.There were 24 males （45 eyes） and 15 females （28 eyes） in ROP group,with an average age of （7.0± 1.28） years.The first laser treatment was carried out at postnatal age （PA） of （38.74±3.82） weeks,the birth weight （BW） of （1402.33 ±369.61） g and the number of laser burns was （517.86 ± 277.40）.The control group included 7 females （13 eyes） and 6 males （12 eyes）,with an average age of （7.17 ± 0.96） years.The age （t=0.691） and gender （x2=1.425） were comparable between the two groups （P=0.491,0.233）.The data of patients and controls were retrospectively analyzed including best corrected visual acuity,refractive examination,automated perimetry test.The differences of the mean deviation （MD） of visual field and the spherical equivalent （SE） between these two groups were comparatively observed.ROP patients were divided into no VF loss group （MD≤2 dB） and VF loss group （MD〉2 dB）,mild VF loss group （MD ≤ 6 dB） and moderate VF loss group （MD 〉6 dB） according to the results of automated perimetry test,the differences of gestational age （GA）,PA,BW,number of laser burns and SE between these groups were comparatively observed.Results The MD in ROP group and control group were 4.87±5.12 dB and 1.27 ± 3.34 dB,respectively;the difference between the two groups was statistically significant （t=-4.01,P〈 0.001）.The subgroup analysis showed that BW,number of laser burns,and SE were significantly different between no VF loss group and VF loss group （t=2.074,-1.996,-2.162;P=0.042,0.026,0.034）;while the GA was not significantly different between these two groups （t=1.973,P=0.052）.The difference of PA was not statistical significant different between mild VF loss group and moderate VF loss group （t=2.03,P=0.051） and SE was significantly different between the above two groups （t=3.283,P=0.002）.For refractive outcomes,the BW and ROP stage correlated with SE significantly （r=-0.304,-0.387;P=0.015,0.002）.The mean BCVA in ROP group was 0.84±0.23,and 59 eyes （91.2%） with BCVA better than 0.5.Conclusion Laser treatment for ROP tends to have less effect on long term refractive status and VF loss,with good visual outcome.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2017年第2期148-152,共5页
Chinese Journal of Ocular Fundus Diseases
关键词
早产儿视网膜病/治疗
激光凝固术/副作用
视野
屈光不正
Retinopathy of prematurity/therapy
Laser coagulation/adverse effects
Visual fields
Refractive errors
