RetCam3早产儿视网膜病变筛查中复方托吡卡胺眼液对散瞳效果及角膜厚度的影响

Effects of compound tropicamide eye drops on mydriasis and corneal thickness in retinopathy of prematurity dcreening with Retcam3

目的通过复方托吡卡胺眼液对散瞳效果及角膜厚度影响的研究,为早产儿视网膜病变筛查提供更适宜的散瞳方法。方法将进行RetCam3早产儿视网膜病变初次筛查并需进行复查的早产儿131人,按不同用药方法分为A、B、C、D四组,分别点入1、2、3、4次托吡卡胺眼液进行散瞳,在距最后一次散瞳15 min、30 min、45 min时测量瞳孔直径和中央角膜厚度(central corneal thickness,CCT)。结果瞳孔散大程度组内比较:A、B、C、D四组内各时间点两两比较差异均有统计学意义(均为P<0.05);组间比较:散瞳15 min时,A组与D组、B组与D组、C组与D组差异均有统计学意义(均为P<0.05);散瞳30 min和45 min时,A组与B组、A组与C组、A组与D组、B组与D组、C组与D组差异均有统计学意义(均为P<0.05)。CCT组内比较:A、B、C、D四组内各时间点间两两比较,差异均有统计学意义(均为P<0.05);组间比较:散瞳30 min和45 min时,A组与C组、A组与D组、B组与C组、B组与D组CCT差异均有统计学意义(均为P<0.05)。结论使用2次散瞳药,在距最后一次散瞳30 min时进行RetCam3早产儿视网膜病变筛查为最佳散瞳方案。

Objective By studying the effects of compound tropicamide eye drops on mydriasis and corneal thickness, to offer a proper way of mydriasis for retinopathy of prematurity screening. Methods A total of 131 preterm infants, who were the research objects of retinopathy of prematurity （ROP） screening, were divided into four groups： Group A, B, C, D according to the first screening and the rescreening of leR eye and right eye. Group A was dropped once the compound tropicamide eye drops to dilate, group B was twice, group C was 3 times, and group D was 4 times. The pupils diameter and central corneal thickness （CCT）were recorded at 15 minutes,30 minutes and 45 minutes since the last drop of compound tropicamide eye drops. Results There was no statistical difference in the mydriatic effect at different time among group A , B, C, D （ all P 〉 0.05 ）. At 15 minutes, differences were found between group A and D, group B and D, group C and D （ all P 〈 0. 05 ） ; At 30 minutes and 45 minutes, differences were found between group A and B, group A and C, group A and D, group B and D, group C and D （ all P 〈 0.05 ）. There were statistical differences in CCT at different time between each two groups （ all P 〈 0.05 ）. At 30 minutes and 45 minutes, differences were found in CCT between group A and C. group A and D. group B and C. group B andD （ all P 〈 0.05）. Conelusion The retinopathy of prematurity screening after dropping twice compound tropicamide eye drops and after 30 minutes since the last drop would be the most proper way of mydriasis.