数字化双目间接检眼镜检查系统在早产儿视网膜病变筛查中的应用

Digital binocular indirect ophthalmoscope for screening of retinopathy of prematurity

目的了解广州市番禺区早产儿视网膜病变发生情况,探讨现阶段适合我国各级医院推广普及应用的早产儿视网膜病变筛查方法。方法按照我国卫生部规定的筛查标准,用数字化双目间接检眼镜检查系统对番禺区185例早产儿及低体质量儿进行眼底检查,观察早产儿视网膜病变的发生情况及检查过程中并发症发生情况。结果发现早产儿视网膜病变者14例14眼,按照我国卫生部的筛查标准计算,发病率为7.57%。其中,早产儿视网膜病变Ⅲ区Ⅰ期者7例,Ⅲ区Ⅱ期者3例,Ⅲ区Ⅲ期者2例,Ⅱ区Ⅲ期者2例,未发现Ⅳ期及Ⅴ期病变,达到阈值期病变需要治疗者2例。检查后,5眼发生不同程度的球结膜下出血,1眼发生急性结膜炎,1例患儿头皮下见大量出血点。未发现有呼吸暂停、休克等严重并发症。结论数字化双目间接检眼镜检查系统既保留了双目间接检眼镜的"金标准"的优点,又增添了视频图像,提供了直观可靠的图片资料,同时还兼具价格低廉的优势,适合各级医院推广应用。

Objective To analyze the incidence of retinopathy of prematurity （ROP） in Panyu district of Guangzhou,and explore an appropriate way for premature screening at present in China for basic-level hospitals. Methods According to the na- tional standards of ROP screening, 185 premature infants were examined with a comput- er-assisted imaging system which incorporated with a binocular indirect ophthalmo- scope, the incidence of ROP and complications in screening process were observed. Re- smlts Among the examined subjects,there were 14 cases with ROP,and the incidence of ROP was 7.5%. Among them,7 cases were in stage Ⅰ of zone Ⅲ,3 cases in stage Ⅱ of zone Ⅲ ,2 cases in stage Ⅲ of zone Ⅲ ,2 cases in stage Ⅲof zone Ⅱ. Two cases reached the threshold disease and needed treatment. After examination,5 eyes had subconjuncti- val hemorrhage with different level, 1 case had scalp hemorrhage,and 1 eye had acute conjunctivitis. No apnea, shock and other severe complication was found. Conclusion The digital binocular indirect ophthalmoscope system not only preserve the ＂gold standard＂ characteristic, but supply the video images, is suitable for ocular fundus ex- amination in primary health organization with cheap and convenience.