南非早产儿视网膜病变筛查:严重ROP的筛查是否及时?来自预期寄存器的数据。

IF 2 Q2 OPHTHALMOLOGY
Tshilidzi van der Lecq, Natasha Rhoda, Esmè Jordaan, Nicola Freeman, Lloyd Tooke, Rudzani Muloiwa, Clare Gilbert, Gerd Holmstrom
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引用次数: 0

摘要

背景/目的:根据现行南非(SA)指南,即在3期和1型ROP发病前,确定早产儿视网膜病变(ROP)筛查是否及时开始。方法:对南非开普敦2022年5月1日至2023年1月31日期间在五个新生儿单位筛查的早产儿进行前瞻性研究。结果:共纳入696名婴儿,58.9% (n=410)的婴儿进行了早期超声(EUS)估计GA。总体而言,220名(31.6%)婴儿发生ROP, 20名(2.9%)为3期或1型,7名(1.0%)需要治疗。549例(78.9%)婴儿在首次筛查时均未出现3期或1型ROP,根据SA标准及时开始筛查。3期和1型ROP分别在PNA和PMA分别为6.3和33.1和8.9和35.9周时首次检测到。大多数婴儿(319例,45.8%)仅根据PNA进行筛查,仅筛查一次的185名婴儿中78.9%未参加后续检查。结论:大多数婴儿在发生严重ROP之前及时开始筛查。由于我们地区EUS的可用性有限,为了促进全面筛查,我们建议在4-6周或出院前单独使用PNA进行筛查,以较早者为准。3期和1型ROP的婴儿比例低是我们研究的一个限制。因此,建议可能无法推广到南非地区,那里的新生儿护理导致婴儿发展为1型ROP的比例较高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Screening for retinopathy of prematurity in South Africa: are those developing severe ROP screened on time? Data from a prospective register.

Background/aims: To determine whether retinopathy of prematurity (ROP) screening is initiated on time according to current South African (SA) guidelines, that is, before the onset of stage 3 and type 1 ROP.

Methods: A prospective study of preterm infants screened at five neonatal units between 1 May 2022 and 31 January 2023 in Cape Town, SA. Data on all infants screened with a birth weight <1250 g or gestational age (GA) <32 weeks were extracted from the ROP South African (ROPSA) register, including postnatal age (PNA) and postmenstrual age (PMA) at first screening.

Results: A total of 696 infants were included, 58.9% (n=410) of whom had an early ultrasound (EUS) for GA estimation. Overall, 220 (31.6%) infants developed ROP, 20 (2.9%) had stage 3 or type 1 and 7 (1.0%) required treatment. Screening was initiated on time according to SA criteria in 549 (78.9%) infants, none of whom had stage 3 or type 1 ROP at first screening. Stage 3 and type 1 ROP were first detected at PNA and PMA of 6.3 and 33.1 and 8.9 and 35.9 weeks, respectively. Most infants (319, 45.8%) were screened according to PNA only, and 78.9% of the 185 infants screened only once did not attend subsequent examinations.

Conclusion: Screening started on time in most infants and prior to the development of severe ROP. Due to the limited availability of EUS in our region and to promote complete screening, we recommend that screening be initiated using PNA alone at 4-6 weeks or prior to discharge, whichever is earliest. The low proportion of infants with stage 3 and type 1 ROP is a limitation in our study. Therefore, recommendations may not be generalisable to South African regions where neonatal care results in a higher proportion of infants developing type 1 ROP.

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来源期刊
BMJ Open Ophthalmology
BMJ Open Ophthalmology OPHTHALMOLOGY-
CiteScore
3.40
自引率
4.20%
发文量
104
审稿时长
20 weeks
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