足月新生儿视网膜白色病变的临床分析与探讨

Clinical analysis and discussion of white retinal lesions in full-term neonates

目的应用眼科广域数字成像系统(Retcam 3)对足月新生儿进行眼病筛查,对筛查结果诊断为视网膜白色病变的患儿进行分析研究。方法对5850例新生儿应用Retcam 3进行眼底筛查,分析所有新生儿眼底筛查结果,统计眼部异常病例。对于筛查结果诊断为视网膜白色病变的患儿,调查其出生情况及母亲孕期情况,分析视网膜白色病变发生的相关因素。结果5850例新生儿中存在眼部异常1067例,筛查异常率为18.2%。其中视网膜出血866例,占异常病例的81.2%,其次为新生儿视网膜白色病变95例,占异常病例的8.9%。在视网膜白色渗出性病变患儿中,双胎3例,脐带绕颈6例,新生儿Apgar评分均为10分。母亲孕期已证实有病毒感染者37例,母亲患有妊娠期高血压疾病23例、妊娠期糖尿病3例。结论母亲孕期有病毒感染与足月新生儿视网膜白色病变的发生密切相关。对于母亲有异常妊娠史的新生儿,在进行眼病筛查时应予以高度重视。另外还应加强孕早期宣教工作,积极采取定期、有效且合适的产前检查。

Objective To study and analyze the newborns with white retinal lesion screened by wide area digital imaging system for ophthalmology (Retcam 3).Methods 5850 newborns were screened with Retcam 3.The results of fundus screening were analyzed and the abnormal cases were counted.For neonates with white retinal lesion diagnosed by screening,their birth and maternal pregnancy were investigated,and the related factors of white retinal lesion were analyzed.Results There were 1067 eye abnormalities in 5850 neonates,and the abnormal rate of screening was 18.2%.There were 866 cases of retinal hemorrhage, accounting for 81.2% of the abnormal cases,followed by 95 cases of neonatal retinal white lesions,accounting for 8.9% of the abnormal cases.Among the children with retinal white exudative lesions,there were 3 cases of twins,6 cases of umbilical cords around the neck,and the newborn Apgar score was 10 points.There were 37 cases of virus infection confirmed during pregnancy,23 cases of gestational hypertension and 3 cases of gestational diabetes mellitus.Conclusion Viral infection during pregnancy is closely related to the occurrence of white retinal lesions in full-term neonates.For newborns whose mothers have a history of abnormal pregnancy,great attention should be paid to ophthalmopathy screening.In addition,early pregnancy education should be strengthened,and regular,effective and appropriate prenatal examinations should be actively taken.