早产儿视网膜病变治疗后屈光状态分析

Analysis on the refractive state after treatment of retinopathy of prematurity

目的 分析早产儿视网膜病变不同方法治疗后的屈光状态.方法 对2013年~2016年60例（114眼）早产儿视网膜病变的临床资料进行回顾性分析.患儿曾随机分为激光治疗组和玻璃体内注射药物治疗组.收集患儿24个月时睫状肌麻痹检影验光资料.并对两组患儿屈光状态和相关因素进行统计学分析.结果 激光治疗组与注药治疗组相比,近视和散光的发生率高,差异有统计学意义（χ2=7.828,2.705;P=0.000,0.007）.激光治疗组的平均球镜度较小、平均柱镜度较大、眼轴较长,差异有统计学意义（χ2=2.329,0.384,2.184;P=0.034,0.007,0.039）.玻璃体内多次注药和单次注药相比,治疗后远视和近视的发生率差异有统计学意义（χ2=2.274,3.052;P=0.023,0.002）.多次注药治疗组的平均球镜度较小、眼轴较长,与单次注药治疗组相比差异有统计学意义（χ2=0.944,2.381;P=0.036,0.042）.结论 玻璃体注药治疗后的ROP患儿,近视和散光发生率低于激光治疗后的患儿,对患儿术后视力的影响小.多次玻璃体内注药的患儿治疗后近视和散光发生率高于单次注药者.

Objective To analyze the refractive state of retinopathy of prematurity （ ROP ） after different methods of treatment .Methods The data of 114 eyes of 60 cases with ROP from 2013 to 2016 were analyzed retrospectively .All cases were divided randomly into laser treatment group and intravitreal injection group .The cycloplegic retinoscopy refraction data of children at 24 months were collected .The refractive status and related factors of the two groups were statistically analyzed .Results The incidence rate of high myopia and astigmatism in laser treatment group were higher than those of intravitreal injection group , the difference were significant between the two groups （χ2 =7.828, 2.705;P=0.000,0.007）.In laser treatment group the spherical equivalent refraction were smaller , the average column mirror degree were smaller and the axial length was longer , the difference were statistically significant between the two groups （χ2 =2.329,0.384,2.184;P=0.034,0.007,0.039） .The differences in the incidence of hyperopia and myopia after treatment were statistically significant between multiple intravitreal injection and single injection （χ2 =2.274, 3.052;P=0.023,0.002 ）.The spherical equivalent refraction were smaller and the axial length were longer in multiple intravitreal injection group , the differences were statistically significant （χ2 =0.944,2.381;P=0.036,0.042）.Conclusion The incidence of myopia and astigmatism are lower after inteavitreal injection for the treatment of ROP , and the effect of vision acuity is small .The incidence of myopia and astigmatism in ROP children treated with intravitreal injection is higher than that of single vitreous body injection for ROP .