不同程度的新生儿视网膜出血对儿童视功能发育的影响

The Influence of Different Degrees of Neonatal Retinal Hemorrhage on Visual Function Development

目的:探讨不同程度的新生儿视网膜出血对儿童眼位及屈光等视功能的影响。方法:对2016-01/2016-12在我院出生的足月新生儿383例766眼于出生后4 d内进行RetCamIII眼底照像检查,并于分别于3个月、6个月、1岁、2岁及3岁时进行眼位及屈光筛查,分析不同程度的新生儿视网膜出血对视功能发育的影响。结果:顺产的新生儿视网膜出血发生率高,不同程度的视网膜出血组的屈光随着年龄的发育均呈现出远视球镜度数随着年龄增长逐渐减低,且各组之间未见明显差异(P 】0.05),而柱镜的绝对值则也呈现出随着年龄增长逐渐减低,并在1岁左右趋于稳定,且各组之间也未见明显差异(P 】0.05)。仅I度视网膜出血组6个月与1岁时的球镜与对照组正常组差异有显著性,III度视网膜出血组在6个月的柱镜与对照组正常组之间差异有显著性(P 【0.05)。III度视网膜出血尤其是玻璃体积血遮盖黄黄斑者斜视发生率远远大于其它组。结论:顺产是视网膜出血的危险因素,新生儿出生后均表现为远视散光,随着年龄的增长,远视度数逐渐减低,散光度数也逐渐减低,一般在1岁左右散光度数趋于稳定,且与视网膜出血无明显的关系,即视网膜出血不影响儿童正常的屈光发育。但是重度的视网膜出血尤其是玻璃体积血长时间遮盖黄斑者可引起形觉剥夺性弱视及知觉性斜视,所以对于重度的玻璃体积血遮盖黄斑者超过3个月积血不吸收,因今早行玻璃体手术清除积血,避免知觉性斜视及形觉剥夺性弱视的发生。

Objective: To explore the influence of different degrees of neonatal retinal hemorrhage on children’s visual function. Methods: From January 2016 to December 2016, a total of 383 full-term newborns were examined by RetCam III fundus photographs within 4 days after birth, and at 3 months, 6 months, 1 year old, 2 years old and 3 years, eye position and refractive screening were performed, analyzes the influence of different degrees of neonatal retinal hemorrhage on visual function development. Results: The refractive index of different degrees of retinal hemorrhage group showed that the degree of hyperopia spherical lens gradually decreased with age, and there was no significant difference between the groups (P >0.05), while the absolute value of the cylinder also showed a gradual decrease with age, and tended to be normal around 1 years old, and there was no significant difference between the groups (P >0.05). Only the spherical lens of the first degree retinal hemorrhage group at 6 months and 1 year old is significantly different from the control group normal group, and the third degree retinal hemorrhage group has a significant difference between the 6 months cylindrical lens and the control group normal group (P