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Annual result of retinopathy of prematurity screening in Shanghai area

Objective To investigate the incidence of retinopathy of prematuri ty (ROP) in the area of Shanghai, and to provide the preliminary data for the ev aluation of present criteria for ROP screening. Methods Record s of 289 prematur e infants who had undergone ROP screening from the four NICU in Shanghai between February 2004 and January 2005 were analyzed. Screening criteria included prete rm infants or low birth weight (LBW) infants with BW of 2000g or less. The first examination starts at 4 to 6 weeks chronologic age or 32 weeks post conceptual age. Results In the 289 screened infants, 19 had developed acu te ROP. There we re 3 threshold ROP, 7 prethreshold ROP and 9 developed ROP less than prethreshol d. The incidence of ROP was 6.6%. According to the British recommended guideline s（BWle;1500 g or GAle;31 weeks）, only 119 out of 289 needed screening and one ca se of stage 1 ROP was missed; the incidence of ROP was 15.1% (18/119). When lowered sc reening criteria to the American guidelines（BWle;1500g or GAle;28 weeks）, t here were only 83 infants needed screening, and we missed 2 stage 1 and 1 prethreshold ROP and the incidence of ROP was 19.3% (16/83). Conclusions The i ncidence of ROP i s 6.6% according to our study. It is lower than other reports and it has somethi ng to do with our present screening guideline. Further epidemiological data are needed to modify the guideline accordingly.

RetCam数字视网膜照相机在早产儿视网膜病变筛查中的应用

The economic evaluation of screening and early diagnosis of primary immunodeficiency diseases: a systematic review

ObjectiveTo systematically review the economics evaluation studies on the early screening or diagnosis of primary immunodeficiency diseases (PID). MethodsWeb of Science, CRD, PubMed, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect the economics evaluation studies on the early screening or diagnosis of PID from inception to July 1st, 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, a descriptive systematic review was performed. ResultsA total of 10 studies focusing on SCID were included. The results showed that under a relatively high threshold, the early screening and diagnosis of SCID were cost-effective, which can reduce severe infections in patients and treatment costs while improving patient’s survival. ConclusionCurrent evidence shows that early diagnosis of PID can reduce costs and improve benefits. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.

出生体重2000~2999g早产儿眼底疾病筛查结果分析

The incidence of retinopathy of prematurity in Shenzhen during the past ten years

ObjectiveTo retrospectively analyze incidence and trends of retinopathy of prematurity (ROP) from 2004 to 2013 in Shenzhen. MethodsA total of 9100 preterm children (5401 males, 3699 females) were screened for ROP in Shenzhen from January 2004 to June 2013 using binocular ophthalmoscope or RetCam Ⅱ. First examination was performed from 4-6 weeks after birth. The birth weight was 520-2990 g with an average of (1710±410) g.The gestational age were 24-36 weeks with an average of (31.57±1.99) weeks. The gestational age of 208 children were <28 weeks, 3608 children were 28-32 weeks, 3553 children was 33-34 weeks, 1731 children was >34 weeks. The ocular findings were recorded according to the International Classification of ROP and The Early Treatment for ROP. Only the more aggressive eye of bilateral asymmetrical cases was counted for statistical purpose, and the cases required surgeries were defined as severe cases. The 10 years period was divided into first phase (2004-2008) and second phase (2009-2013). The incidence of ROP and severe ROP of these two phases was compared and statistics was analyzed. ResultsIn the past 10 years, the overall incidence of ROP and sever ROP in Shenzhen was 12.49% and 4.99% in this screen. The children were divided into 4 groups according to the birth weight, the ROP incidences of birth weight <1000 g, 1000-1499 g, 1500-1999 g and ≥2000 g were 62.62%, 28.40%, 11.34% and 3.63% respectively. The severe ROP incidences were 34.95%, 12.21%, 3.73% and 0.49% respectively in these birth weight groups. The children were divided into 4 groups according to gestational weeks, the ROP incidences of gestational age <28 weeks, 28-32 weeks, 33-34 weeks and >34 weeks were 67.31%, 25.27%, 7.22% and 3.87% respectively. Severe ROP incidences were 37.02%, 10.71%, 1.79% and 0.68% in these gestational age groups respectively. ROP and severe ROP incidences were decreased from 14.64% at first phase to 11.47% at second phase, and from 6.52% at first phase to 4.26% second phase respectively, the differences were statistical significant (χ2=26.96, 26.61; P<0.05). ROP and severe ROP incidence in <1000 g birth weight group at second phase were much less than the first phase (χ2=13.676, 5.271; P<0.05). In <28 weeks gestational age group, the ROP incidence was the same in first phase and second phase (χ2=0.843, P>0.05), but the severe ROP incidence at second phase was much less the first phase (χ2=4.757,P<0.05). ConclusionFrom 2004 to 2013, the incidences of ROP and severe ROP have decreased significantly in Shenzhen.

Screening and risk factors analysis of retinopathy of prematurity in Hubei

Objective To investigate the incidence and risk factors associated with the development of retinopathy of prematurity (ROP) in Hubei province. MethodsFrom July 2009 to May 2011, 313 premature infants (626 eyes) with gestational age less than 37 weeks were examined by indirect ophthalmoscopy and RetCamⅡ as part of ROP screening.Two hundred infants were male and 113 were female. Their birth weight was from 890 to 3500 grams, with a mean of (1977.37±497.03) grams. Their gestational age was from 26 to 37 weeks, with a mean of (33.13±2.44) week. The infants were divided into ROP group and non-ROP group according to the results of screening. All infants were followed up until retinopathy was stable or received laser therapy as the requirements of prevention and control guidelines of ROP. The sex, gestational age, birth weight, delivery mode, IVF baby, multiple pregnancy, oxygen therapy, intrauterine hypoxia, eclampsia, threatened abortion, oxygen history of infants, respiratory distress syndrome, hypoxicischemic encephalopathy, jaundice, and blueray radiation therapy in two groups were statistically analyzed. ResultsIn 313 infants (626 eyes), ROP developed in 52 infants (16.61%) and 87 eyes (13.90%), which including 2 eyes suffering from AP-ROP, 38 eyes from stage 1, 36 eyes from stage 2, 11 eyes from stage 3. There were 261 infants (83.39%) and 539 eyes (8610%) in nonROP group. Eleven infants (20 eyes) received laser therapy. The results of statistical analysis showed that gestation age(t=-4.348), birth weight (t=-3.966), oxygen therapy (χ2=9.05;OR=3.403, 95%CI=1.475 - 7.854) were significantly related to ROP (P＜0.05).ConclusionThe incidence of ROP in Hubei province is 16.61%. The gestation age, birth weight and oxygen therapy are closely related to the occurrence of ROP.

安徽省妇幼保健院1041名早产儿或低体重儿早产儿视网膜病变筛查结果

Safety of inhalation anesthesia in preterm children of different corrected gestational ages undergoing ocular fundus examination

Objective To observe the systemic inhalation anesthetic effects of preterm children with different gestational ages under ocular fundus examination, and to assess its safety. Methods Fifty-one preterm children with retinopathy of prematurity (ROP) were included in the study. These kids were divided into 2 groups, group Ⅰ included 24 kids with a corrected gestational age of 33 to ＜44 weeks, and group Ⅱ included 27 kids with a corrected gestational age of 44 to 64 weeks. The preterm months were same (t=-1.3.P＞0.05), but the body weights were different (t=-10.5.P＜0.05) between these two groups. Anesthesia was induced by inhalation of 6% sevoflurane, and the period from the beginning of inhalation to disappearance of body movement was the induction time. 6% sevoflurane was inhaled continuously for another period of the induction time, and then the concentration of sevoflurane was adjusted to a maintenance concentration. The initial maintenance concentration was 3%, and was adjusted by 0.5% each time. Sequential method was used to determine the subsequent maintenance concentration. If the preceding patient had not moved during the maintenance period, the sevoflurane concentration was decreased by 0.5% for the next patient. If the preceding patient had moved during the maintenance period, the sevoflurane concentration was increased by 0.5% for the next patient. Respiratory depression and cough during the induction and maintenance period, duration of anesthesia and recovery time were recorded. Choking and vomiting during drinking or milk-feeding in one hour after the ocular fundus examination were also recorded. Results The effective inhale concentration in 50% patient of sevoflurane was 2.5% in group Ⅰ, 2.9% in group Ⅱ. The average maintenance concentration was (2.5plusmn;0.5)% in group Ⅰ, (3.0plusmn;0.5)% in group Ⅱ. The difference was statistically significant (t=-3.3.P＜0.05). The average duration of anesthesia and the average awake time were the same (t=0.04 and -1.0 respectively.P＞0.05) between these two groups. The average induction time was significantly shorter in group Ⅰ than in group Ⅱ, the difference was statistically significant (t=-4.9.P＜0.05). All patients were successfully completed the ocular examination. No respiratory depression or cough occurred during and after the examination. No choking and vomiting during drinking or milkfeeding in one hour after the ocular fundus examination. Conclusion Anesthesia with inhaled sevoflurane by a face mask is safe for preterm outpatients undergoing fundus examination.

Clinical analysis of retinopathy of prematurity

Objectives To observe the characteristics of occurrence a nd progres s of retinopathy of prematurity (ROP) in premature infants and search the reason able ROP screening time and therapeutic methods.〓〖WTHZ〗Methods〓〖WTBZ〗ROP s creening was perf ormed on 829 infants, with the gestational agele;35 weeks and the birth weightle; 2000 g, by indirect ophthalmoscopy combined with scleral pressurizing implement. Thirtytwo infants with prethreshold type I and threshold ROP underwent cryot he rapy. The followup duration after the operation was 316 months, and the crit er ia of the control of the diseases included: alleviation of the plus disease, all eviation of the vascular ridge, formation of the cryospots, absorption of vitr e oretinal hemorrhage, and non bad retinal structure. If the disease was not contr olled, recryotherapy or vitrectomy would be carried out.〓〖WTHZ〗Results〓〖W TBZ〗ROP was fou nd in 86 infants (172 eyes). The difference of oxygen duration time among ROP g roups and nonROP group was significant; the occurrence rate of ROP in the infa n ts with the birth weightle;1000 g, 10011500 g and 15012000 g was 6956%, 16 38% , and 414%, respectively; the occurrence rate of ROP in the infants with the g estat ional agele;30 weeks, 3132 weeks, and 3335 weeks was 37.14%, 10.43%, and 2.91 %, respectively; the occurrence rate of ROP in singleembryo infants group and mul t iple embryo infants group was 7.52% and 20.22%, respectively. Favorable outcom e was observed in 30 out of 32 infants who had undergone cryotherapy; 2 infants d eveloped retinal detachment with plus disease and peripheral retinal hemorrhage. The sccess rate of cryotherapy is high in the infants with the gestational age lt;32 weeks.〓〖WTHZ〗Conclusions〓〖WTBZ〗The ROP incidence rate is higher in the infants with lo ng oxygenbreathing duration, birth weighle;1000 g, and gestational age le; 32 we ek infants, which should be screened carefully. The infants having ROP onset within 32 weeks, with plus disease, and peripheral retinal hemorrhage should be follow ed up closely. The prognosis of cryotherapy for type I prethreshold and thresh old ROP is good and the operation is safe.

261例青海新生儿重症监护病房早产儿视网膜病变筛查及相关危险因素分析