Background: Retinopathy of prematurity (ROP) is one of the few causes of childhood blindness in which severe vision impairment is largely preventable. Ophthalmic screening for ROPis required to identify disease that r...Background: Retinopathy of prematurity (ROP) is one of the few causes of childhood blindness in which severe vision impairment is largely preventable. Ophthalmic screening for ROPis required to identify disease that requires treatment whereby the development of potentially blinding disease can be minimised. Objectives: To make the first UK population based estimate of the incidence of babies with severe ROP(stage 3 or more); to document their clinical characteristics and management and to evaluate the appropriateness of current ROPscreening guidelines in the UK. Patients: Cases were recruited through a national surveillance programme with 1 year ophthalmic follow up and data from clinician completed questionnaires. Results: Between 1 December 1997 and 31 March 1999, 233 preterm babies with stage 3 ROP were identified. Severity (location, extent, and presence of plus disease) was associated with degree of prematurity, most severe in the most premature babies. Fifty nine percent were treated. The UK screening protocol was followed in two thirds of cases, but in the remainder it was begun too late or was too infrequent. Three quarters of the cases were followed up at 1 year, and 13%had a severe vision deficit as a result of ROP. Conclusions: Visual deficit as a result of ROPin premature babies continues to be a severe disability in some of the survivors of neonatal intensive care. Further efforts are needed to organise treatment regionally to improve outcome and standards of practice.展开更多
Background: Retinopathy of prematurity (ROP) is one of the few causes of child hood blindness in which severe vision impairment is largely preventable. Ophthal mic screening for ROP is required to identify disease tha...Background: Retinopathy of prematurity (ROP) is one of the few causes of child hood blindness in which severe vision impairment is largely preventable. Ophthal mic screening for ROP is required to identify disease that requires treatment wh ereby the development of potentially blinding disease can be minimised. Objectiv es: To make the first UK population based estimate of the incidence of babies wi th severe ROP (stage 3 or more); to document their clinical characteristics and management and to evaluate the appropriateness of current ROP screening guidelin es in the UK. Patients: Cases were recruited through a national surveillance pro gramme with 1 year ophthalmic follow up and data from clinician completed questi onnaires. Results: Between 1 December 1997 and 31 March 1999, 233 preterm babies with st age 3 ROP were identified. Severity (location, extent, and presence of plus dise ase) was associated with degree of prematurity, most severe in the most prematur e babies. Fifty nine percent were treated. The UK screening protocol was followe d in two thirds of cases, but in the remainder itwas begun too late orwas too in frequent. Three quarters of the cases were followed up at 1 year, and 13%had a severe vision deficit as a result of ROP. Conclusions: Visual deficit as a resul t of ROP in premature babies continues to be a severe disability in some of the survivors of neonatal intensive care. Further efforts are needed to organise tre atment regionally to improve outcome and standards of practice.展开更多
Distortion product otoacoustic emissions (DPOAEs) were recorded in 46 term infants who suffered perinatal hypoxia-ischaemia to identify which frequencies in the cochlear audiogram are susceptible to perinatal hypoxia-...Distortion product otoacoustic emissions (DPOAEs) were recorded in 46 term infants who suffered perinatal hypoxia-ischaemia to identify which frequencies in the cochlear audiogram are susceptible to perinatal hypoxia-ischaemia.On days 3-5 after birth, the pass rates across the frequencies of the f2 primary tone between 1 and 10 kHz, particularly 1-5 kHz, were all lower than those in normal term controls (X2 = 7.27-32.30, all P < 0.01).Of the 92 ears, 15 (16.3%) failed the DPOAE test, which was significantly higher than in the controls (4.3%, X2 = 5.81, P < 0.05).At 1 month, 80 ears with a type A tympanogram were retested.The pass rates at most frequencies, mainly 1 and 2 kHz, were slightly further decreased.Thirteen ears (16.2%) failed the DPOAE test.These results suggest that the neonatal cochlea, mainly at the frequencies 1-5 kHz, is impaired shortly after perinatal hypoxia-ischaemia and the impairment remains at 1 month.Conclusion: Perinatal hypoxia-ischaemia impairs the neonatal cochlea mainly at the frequencies 1-5 kHz and the impairment detected on days 3-5 after birth is unlikely to improve in the later neonatal period.These findings may have implications for the management of hearing impairment in infants after perinatal hypoxia-ischaemia.展开更多
文摘Background: Retinopathy of prematurity (ROP) is one of the few causes of childhood blindness in which severe vision impairment is largely preventable. Ophthalmic screening for ROPis required to identify disease that requires treatment whereby the development of potentially blinding disease can be minimised. Objectives: To make the first UK population based estimate of the incidence of babies with severe ROP(stage 3 or more); to document their clinical characteristics and management and to evaluate the appropriateness of current ROPscreening guidelines in the UK. Patients: Cases were recruited through a national surveillance programme with 1 year ophthalmic follow up and data from clinician completed questionnaires. Results: Between 1 December 1997 and 31 March 1999, 233 preterm babies with stage 3 ROP were identified. Severity (location, extent, and presence of plus disease) was associated with degree of prematurity, most severe in the most premature babies. Fifty nine percent were treated. The UK screening protocol was followed in two thirds of cases, but in the remainder it was begun too late or was too infrequent. Three quarters of the cases were followed up at 1 year, and 13%had a severe vision deficit as a result of ROP. Conclusions: Visual deficit as a result of ROPin premature babies continues to be a severe disability in some of the survivors of neonatal intensive care. Further efforts are needed to organise treatment regionally to improve outcome and standards of practice.
文摘Background: Retinopathy of prematurity (ROP) is one of the few causes of child hood blindness in which severe vision impairment is largely preventable. Ophthal mic screening for ROP is required to identify disease that requires treatment wh ereby the development of potentially blinding disease can be minimised. Objectiv es: To make the first UK population based estimate of the incidence of babies wi th severe ROP (stage 3 or more); to document their clinical characteristics and management and to evaluate the appropriateness of current ROP screening guidelin es in the UK. Patients: Cases were recruited through a national surveillance pro gramme with 1 year ophthalmic follow up and data from clinician completed questi onnaires. Results: Between 1 December 1997 and 31 March 1999, 233 preterm babies with st age 3 ROP were identified. Severity (location, extent, and presence of plus dise ase) was associated with degree of prematurity, most severe in the most prematur e babies. Fifty nine percent were treated. The UK screening protocol was followe d in two thirds of cases, but in the remainder itwas begun too late orwas too in frequent. Three quarters of the cases were followed up at 1 year, and 13%had a severe vision deficit as a result of ROP. Conclusions: Visual deficit as a resul t of ROP in premature babies continues to be a severe disability in some of the survivors of neonatal intensive care. Further efforts are needed to organise tre atment regionally to improve outcome and standards of practice.
文摘Distortion product otoacoustic emissions (DPOAEs) were recorded in 46 term infants who suffered perinatal hypoxia-ischaemia to identify which frequencies in the cochlear audiogram are susceptible to perinatal hypoxia-ischaemia.On days 3-5 after birth, the pass rates across the frequencies of the f2 primary tone between 1 and 10 kHz, particularly 1-5 kHz, were all lower than those in normal term controls (X2 = 7.27-32.30, all P < 0.01).Of the 92 ears, 15 (16.3%) failed the DPOAE test, which was significantly higher than in the controls (4.3%, X2 = 5.81, P < 0.05).At 1 month, 80 ears with a type A tympanogram were retested.The pass rates at most frequencies, mainly 1 and 2 kHz, were slightly further decreased.Thirteen ears (16.2%) failed the DPOAE test.These results suggest that the neonatal cochlea, mainly at the frequencies 1-5 kHz, is impaired shortly after perinatal hypoxia-ischaemia and the impairment remains at 1 month.Conclusion: Perinatal hypoxia-ischaemia impairs the neonatal cochlea mainly at the frequencies 1-5 kHz and the impairment detected on days 3-5 after birth is unlikely to improve in the later neonatal period.These findings may have implications for the management of hearing impairment in infants after perinatal hypoxia-ischaemia.
