Screening for retinopathy of prematurity:a report from upper Egypt

AIM： To detect the incidence of retinopathy of prematurity （ROP） in a tertiary referral neonatal intensive care unit in upper Egypt and to describe the obstacles faced during implementing the screening protocol for the first time. METHODS： Consecutive infants were enrolled at birth and screened for ROP. We used the UK ROP guideline （May 2008） for infant selection, follow up and treatment. Repeat examinations were performed until retinal vascularisation was complete. RESULTS： Fifty-two infants were enrolled： 24 males and 28 females. Mean gestational age was 31.3wk （±2.8 SD） and mean birth weight was 1234,6 g （±221.1 SD）. Incidence of ROP was 36.5% （stages 1, 2, 3 and 4a were 9.6%, 9.6%, 15.4% and 1.9% respectively）, no stages 4b or 5 were found in this series. Six infants （11.5%） died during screening without ROP, 25 infants （48.1%） were discharged from screening with retinal vascularisation reaching zone III, 5 infants （9.6%） were treated with indirect diode with or without additional cryotherapy and 16 infants （30.8%） were lost to follow up. In this series gestational age rather than birth weight was found significantly correlated and predictive （P〈0.05） with ROP stages. CONCLUSION： ROP in a single site in upper Egypt appears to have comparable incidence to other areas worldwide. The main screening obstacle was missing cases due to the absence of a national ROP screening protocol.

Preferred practice guidelines for retinopathy of prematurity screening during the COVID-19 pandemic

Retinopathy of prematurity(ROP)is the leading cause of preventable infant blindness in the world and predominantly affects babies who are born low birth weight and premature.India has the largest number of surviving preterm births born annually.ROP blindness can be largely prevented if there is a robust screening program which detects treatment requiring disease in time.ROP treatment must be provided within 48 h of reaching this threshold of treatment making it a relative emergency.During the severe acute respiratory syndromecoronavirus disease 2019 pandemic in 2020 ROP screening was disrupted throughout the world due to lockdowns and restriction of movement of these infants,their families,specialists and healthcare workers.The Indian ROP Society issued guidelines for ROP screening and treatment in March 2020,which was aimed at preserving the chain-of-care despite the potential limitations and hazards during the(ongoing)pandemic.This preferred practice guideline is summarized in this manuscript.

Incidence and risk factors of retinopathy of prematurity and utility of the national screening criteria in a tertiary center in Iran

AIM: To determine the incidence and risk factors of retinopathy of prematurity(ROP) and the sensitivity of current screening criteria in a tertiary eye center in Tehran, Iran. METHODS: In a cross-sectional observational study, neonates weighing ≤2000 grams at birth or born <34 wk gestational age(GA) and all other infants at risk of ROP admitted to the neonatal intensive care unit(NICU) or referred to our ROP clinic were investigated. The incidence of ROP and severe ROP(i.e. patients needing treatment) were determined. The associations between risk factors and the development and severity of ROP were assessed. We also examined the sensitivity of the current national screening guideline in Iran. RESULTS: Among 207 infants, the incidence of ROP and severe ROP was 33.3% and 11.1%, respectively. Mean GA and birth weight(BW) were significantly lower in ROP vs non-ROP infants(29±2 wk vs 33±3 wk, P<0.001;1274±489 g vs 1916±550 g, P<0.001, respectively). Univariate analysis displayed significant association between ROP incidence and GA, BW, NICU admission period, blood transfusion, surfactant usage, sepsis, intraventricular hemorrhage and patent ductus arteriosus(P<0.05 for all). BW [relative risk(RR): 0.857(0.711-0.873), P<0.001], GA [RR: 0.788(0.711-0.873), P<0.001] and blood transfusion [RR: 1.888(0.995-3.583), P=0.052] were independent ROP risk factors. The sensitivity of country-specific screening guidelines was 95.7% and 100% for overall and severe ROP detection, respectively. CONCLUSION: ROP incidence is relatively high in Iran. Identifying ROP risk factors results in more accurate screening and reduces the risk of irreversible vision loss. The ROP screening criteria utilized in Iran are efficient at the present time.

Systemic changes and adverse effects induced by retinopathy of prematurity screening

AIM: To estimate the potential systemic events during and after retinopathy of prematurity (ROP) screening. ' METHODS: A prospective and descriptive designed study was conducted to detect the physiologic and pathological changes 24h before, during, and 72h after ROP screening. Control blood pressure (BP), saturation, pulse rate, and body temperature were routinely taken at various time internals before and after screening. Adverse effects pertain to cardiovascular system, respiratory system, gastric system, urinary system and nervous system were retrospect 0-72h after ROP screening at a 24-hour interval. RESULTS: Totally 1254 prematurity babies receiving ROP screening during Jan. 1st 2013 to Dec. 31th 2013 were enrolled in our survey. Compared to control vital sign data taken before the examination, there was a fluctuation in the diastolic BP with the increased 3.03 mm Hg (P=0.04) after 3 doses of mydriatic drops. Immediately after the examination, there was a further 12.64 mm Hg (P<0.01) increase in systolic BP and a 7.24 mm Hg (P<0.01) in diastolic BP. The mean pulse rate during examination was 22.4 bpm (P<0.01) higher than the 133.3 +/- 9.0 bpm control level. The oxygen saturation shared an average drop of 5% (P<0.01) during screening. In prematurity with postconceptional age less than 31wk, the incidence of apnea (23.5%), necrotizing enterocolitis (NEC) (8.7%), gastric residual (25.4%) and upper digestive tract hemorrhage (6.4%) also demonstrated a significant rise (P<0.01). CONCLUSION: In our study sample, ROP screening was associated with NEC, gastric residual and upper digestive tract hemorrhage. These gastrointestinal side effects, along with breath activity pattern change and vital signs indicators fluctuation, may be results of additional stress responses.

The Alexandria retinopathy of prematurity model(Alex-ROP): postnatal weight gain screening algorithm application in a developing country

AIM: To suggest a novel retinopathy of prematurity(ROP) screening model in developing countries incorporating postnatal weight gain ratios(PWGR) to traditional parameters to maintain sensitivity and improve specificity in detecting ROP. METHODS: Analysis of weekly PWGR of infants from one tertiary referral center during six months to determine the age at which the PWGR with the highest predictability for ROP development which was referred to as the postnatal net weight gain ratio(NWGR). NWGR was added to conventional criteria to describe a new model(The Alex-ROP model). RESULTS: Of 560 infants were included. NWGR 28 d after birth was the most predictive factor for the development of ROP. A new model Alex-ROP recommending screening infants with gestational age(GA) ≤33 wk or birth weight ≤1500 g and NWGR at 28 d after birth <0.3 was suggested. A second screening model referred to as High-grade AlexROP(Hg Alex-ROP) model to detect worse grade ROP(Both type 1 and type 2) recommending a cutoff point of NWGR <0.15 between birth and 28^(th) day. CONCLUSION: Both Alex-ROP and Hg Alex-ROP models are easy to apply to improve the specificity of ROP screening in developing countries while maintaining high sensitivity.

Retinopathy of prematurity: Past, present and future

Retinopathy of prematurity(ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of preterm babies, ROP has become the leading cause of preventable childhood blindness throughout the world. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. Although screening guidelines and protocols are strictly followed in the developed nations, it lacks in developing economies like India and China, which have the highest number of preterm deliveries in the world. The burden of this blindness in these countries is set to increase tremendously in the future, if corrective steps are not taken immediately. ROP first emerged in 1940 s and 1950 s, when it was called retrolental fibroplasia. Several epidemics of this disease were and are still occurring in different regions of the world and since then a lot of research has been done on this disease. However, till date very few comprehensive review articles covering all the aspects of ROP are published. This review highlights the past, present and future strategies in managing this disease. It would help the pediatricians to update their current knowledge on ROP.

Expression and function of Delta-like ligand 4 in a rat model of retinopathy of prematurity

The Delta-like ligand 4/Notch signaling pathway was shown to participate in the process of retinal development and angiogenesis. However, the function of the Delta-like ligand 4/Notch signaling pathway in retinopathy of prematurity requires further study. Retinopathy of prematurity was induced in 5-day-old Sprague-Dawley rats exposed to hyperoxia for 7 days, and then returned to room air. Reverse transcription-PCR and western blot revealed that Delta-like ligand 4 levels decreased at postnatal day 12 and increased at postnatal day 17 in retinopathy of prematurity rats. Flat-mounted adenosine diphosphatase stained retina and hematoxylin-eosin stained retinal tissue slices showed that the clock hour scores and the nuclei counts in retinopathy of prematurity rats were significantly different compared to normal control rats. After retinopathy of prematurity rats were intravitreally injected with Delta-like ligand 4 monoclonal antibody to inhibit the Delta-like ligand 4/Notch signaling pathway, there was a significant increase in the severity of retinal neovascularization （clock hours） in the intravitreally injected eyes. The nuclei count was highly correlated with the clock hour score. These results suggest that Delta-like ligand 4/Notch signaling plays an essential role in the process of physiological and pathological angiogenesis in the retina.

The Indian retinopathy of prematurity society:a baby step towards tackling the retinopathy of prematurity epidemic in India

Background:India leads all nations in the number of preterms born annually.With over 3.5 million infants,a reducing infant mortality rate and an expanding base of rural neonatal intensive care units,the number of infants requiring retinopathy of prematurity(ROP)screening has dramatically increased.The number of ROP specialists in the country is currently inadequate.Leading ROP specialists of the country initiated the Indian ROP(IROP)society to address these challenges.Methods:In 2016,the IROP society was conceived and registered as a professional body with a mission to prevent needless blindness from ROP by promoting standards of excellence.A national online membership drive was carried out.The data collected in this survey was analyzed to collate information on past training,practice patterns,ease of screening and treatment,use of wide-field imaging and willingness to be certified.Results:Of the 113 members at the time of submission,67.3%were male.88.5%were formally trained for ROP and 85.8%were vitreo-retinal specialists.Of the practicing members,96%were“comfortable”with screening and 86%with ROP treatment and this correlated with training(P=0.001 and P=0.002 respectively).Only 25.7%performed vitreous surgery for ROP.Wide field imaging was used by 33%of members in their practice and 52%of those who did not,wanted to use it in the future.Members who used imaging performed more number of laser treatments than those who did not(P=0.008).Laser was the preferred modality of treatment for 98%of members.A majority of the members(92.5%)were willing to be audited.Conclusions:The IROP society is a novel platform for ROP specialists to collaborate.The society has setup short,mid and long-term goals to make ROP care more accessible and affordable with appropriate use of technology.

Current understanding and management of aggressive posterior retinopathy of prematurity

Aggressive posterior retinopathy of prematurity(ROP), previously referred to as "Rush disease", is a rapidly progressive form of ROP. This form of ROP typically presents in very low birth weight babies of early gestational age. Historically, anatomical and functional outcomes have been poor with standard treatment. This review is designed to discuss current knowledge and treatment regarding this aggressive form of ROP. Recommendations regarding management of these difficult cases are detailed.

Clinical features and characteristics of retinopathy of prematurity in developing countries

Retinopathy of prematurity(ROP)is an emerging cause of childhood blindness in the developing countries.The low and middle-income countries are facing common challenges in the midst of the‘third epidemic’of ROP.Improvement in neonatal care facilities has increased survival of preterm babies.Lack of awareness and non-uniform standards of care in the ever-increasing number of neonatal intensive care units(NICUs)and special newborn care units(SNCUs)has resulted in this surge of ROP.Apart from low birth weight and the degree of prematurity,use of unblended supplemental oxygen,sepsis,anemia and blood transfusion are important risk factors associated with ROP in developing countries.Atypical forms of aggressive posterior ROP(APROP)are seen in heavier birth weight babies in the developing countries.Prevention of ROP by good quality neonatal care,timely diagnosis by mandatory ROP screening in NICUs and training manpower for laser treatment of ROP requires close collaboration between the neonatologists,ophthalmologists and the policy makers.Team approach and inter-disciplinary co-ordination are keys in a nation’s drive to fight this preventable cause of blindness.

珠海地区早产儿视网膜病变发病趋势分析

目的分析珠海地区近十二年来早产儿视网膜病变(ROP)的发病情况及变化趋势。方法收集2010年1月至2022年12月在珠海市妇幼保健院眼科(本院)和珠海市人民医院新生儿科住院的早产儿和本地区医院经治疗出院后在本院眼科进行ROP筛查的10490例早产儿资料。回顾分析12年来的ROP总体发病率、重症率,并分为三个阶段(2010—2013年、2014—2017年和2018—2022年)记录ROP发病情况及其变化趋势。结果10490例早产儿中发生不同程度的ROP177例,发病率为1.69%,其中重症ROP25例,占筛查人数的0.24%。总体上ROP发病率有轻度上升倾向,从第一、第二阶段的1.55%、1.62%上升至第三阶段的1.85%;总体上ROP的重症率有下降趋势,从第一阶段的0.28%降至第三阶段的0.24%,中间微有波动,差异无统计学意义(P>0.05)。出生体质量<2000g的患儿ROP的发病率三个阶段比较有上升趋势,从第一阶段、第二阶段的5.37%、4.66%升至第三阶段的5.70%;ROP的重症率三个阶段比较有下降趋势,从第一阶段的1.10%降至第三阶段的0.81%,差异无统计学意义(P>0.05)。出生胎龄≤34周的患儿ROP发病率三个阶段比较有上升趋势,从第一阶段、第二阶段的3.91%、3.85%升至第三阶段的4.31%;ROP重症率三个阶段比较有下降趋势,从第一阶段、第二阶段的0.80%、0.59%降至第三阶段的0.59%,差异无统计学意义(P>0.05)。不同出生体质量早产儿组间比较,ROP发病率及重症率随出生体质量降低有明显增高趋势,差异有统计学意义(P<0.05)。不同出生胎龄早产儿组间比较,ROP发病率及重症率随胎龄减少有明显增高趋势,差异有统计学意义(P<0.05)。结论珠海地区12年来ROP三个阶段的发病率及重症率总体平稳,呈现出生体质量越低和出生胎龄越小ROP的发病率逐渐增高趋势;ROP发病特点以轻症为主,重症ROP发生于出生体质量<2000g、胎龄≤32周的早产儿。

多点反馈护理模式在早产儿视网膜病变眼底筛查中的应用

目的探究多点反馈护理模式在早产儿视网膜病变(ROP)眼底筛查中的应用效果。方法选取2021年1月至2023年1月医院收治的120例早产儿为研究对象,按照随机数字表法分为观察组和对照组,各60例,对照组接受常规护理干预,观察组在对照组的基础上加以多点反馈护理干预,比较两组ROP筛查结果、早产儿家属疾病认知度、遵医行为、眼部并发症及护理质量。结果两组ROP筛查例数比较,差异无统计学意义(P>0.05),但病变分期分布比较,差异有统计学意义(P<0.05);观察组早产儿家属疾病认知度、遵医行为评分均高于对照组,并发症发生率低于对照组(P<0.05)。观察组护理质量评分高于对照组(P<0.05)。结论多点反馈护理模式可提高早产儿家属疾病认知度、遵医行为,有助于ROP早期眼底筛查,整体护理质量较高,值得推荐。

舌尖滴入24%蔗糖水联合白噪声对减轻早产儿视网膜病筛查操作性疼痛反应的影响

目的观察舌尖滴入24%蔗糖水联合白噪声对减轻早产儿视网膜病(ROP)筛查操作性疼痛反应的影响。方法选取2021年6月至2022年6月江西省赣州市人民医院新生儿重症监护病房收治的80例首次进行ROP筛查的患儿作为研究对象,按照随机数字表法分为对照组(20例)、干预1组(20例)、干预2组(20例)与干预3组(20例),对照组实施常规体位安抚法和非营养性吸吮,在对照组基础上,干预1组实施舌尖滴入微量24%蔗糖水,干预2组实施白噪声,干预3组实施舌尖滴入24%蔗糖水联合白噪声,比较各组疼痛缓解程度、体征指标异常改善情况。结果筛查前3min,四组患儿的早产儿疼痛量表(PIPP-R)总分、心率(HR)、呼吸频率(RR)及经皮血氧饱和度(SpO2)水平比较,差异无统计学意义(P>0.05);筛查结束后1 min,四组患儿的HR、RR以及PIPP-R总分均高于本组筛查前3min,SpO2水平低于本组筛查前3min,差异有统计学意义(P<0.05);筛查结束后5min,四组患儿的HR和RR、PIPP-R总分低于本组筛查结束后1min,SpO2水平高于本组筛查结束后1min,且干预3组患儿筛查结束后5 min的PIPP-R总分、HR及RR低于干预1、2组和对照组,SpO2水平高于干预1、2组和对照组,差异有统计学意义(P<0.05)。结论舌尖滴入24%蔗糖水联合白噪声在ROP筛查操作性疼痛反应中的应用效果较好,能够改善患儿心率及呼吸频率,减少哭闹,抚慰其情绪和行为表现,也有助于提高患儿家属对医护工作的满意度。

早产儿视网膜病变高危因素Logistic分析

目的探讨早产儿视网膜病变(ROP)高危因素,为本病预防工作提供有利参考。方法以安阳市妇幼保健院2021年1月至2023年1月808例住院早产儿为筛查对象,应用广角数码视网膜成像系统(RetCam3)进行眼底筛查,根据是否发生ROP分组。比较两组一般临床资料,Logistic多因素回归分析ROP发生的危险因素。结果本研究808例早产儿中ROP有82例,非ROP有726例,ROP检出率为4.22%。ROP组胎龄、出生体重及血清血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)、锌(Zn)、铜(Cu)水平与非ROP组比较差异有统计学意义(P<0.05)。血清VEGF(>295.33 ng/L)、Zn(>0.55 mg/L)是早产儿发生ROP的危险因素;胎龄(>33.10周)、出生体重(≥1500 g)、IGF-1(>35.39 ng/mL)、Cu(>0.69 mg/L)是早产儿发生ROP的保护因素。结论早产儿发生ROP的影响因素包括胎龄、出生体重及血清VEGF、IGF-1、Zn、Cu水平,临床应针对其高危因素采取有效措施或提早干预,进而预防/减少早产儿ROP发生。

英国早产儿视网膜病变的筛查和治疗指南2022更新版解读

英国早产儿视网膜病变的筛查和治疗指南2022更新版由英国皇家儿科与儿童健康学院和皇家眼科学院的多学科指南制订小组按照英国国家卫生与临床优化研究所标准制订,于2022年3月发表在英国皇家儿科与儿童健康学院网站和皇家眼科学院网站,2023年3月在Early Human Development杂志正式发表。该指南对早产儿视网膜病变的筛查及治疗进行了循证推荐和建议。与更新前的指南相比,2022更新版最重要的变化是将胎龄筛查标准降至31周以下;治疗部分涵盖了早产儿视网膜病变的治疗适应证、时间、方法及随诊。该文对该指南进行解读并与国内早产儿视网膜病变指南/共识进行比较,为国内同行提供参考和借鉴。

《产后生长和早产儿视网膜病变(G-ROP)筛查标准》(简化版)在严重早产儿视网膜病变筛查中的应用

目的评估简化版产后生长和早产儿视网膜病变(G-ROP)筛查标准检测严重早产儿视网膜病变(ROP)的准确性,并与现行的筛查标准及本研究推荐的筛查标准进行比较。方法回顾性选取2015年1月至2022年12月在四川省人民医院进行的ROP筛查的早产儿1286例为研究对象。所有受检者均在散瞳后使用双目间接眼底镜或广角数码儿童视网膜成像系统(Retcam)按常规操作进行眼底检查。详细收集受检者出生体重、出生孕周、性别以及眼底检查结果等临床资料。根据《中国早产儿视网膜病变筛查指南(2014年)》对眼底病变进行诊断及治疗(筛查标准为BW<2000 g,或GA<32周)。简化版G-ROP筛查标准定义为:出生体重<1051 g,或出生孕周<28周;推荐的筛查标准定义为:出生体重1500 g,或出生孕周≤30周。应用受试者工作特征(ROC)曲线对筛查标准检测严重ROP的性能进行分析。结果共302例(23.5%,302/1286)受检者符合简化版G-ROP筛查标准,其中159例(52.6%,159/302)为严重ROP。共134例(45.7%,134/293)严重ROP被漏诊。ROC分析结果显示,简化版G-ROP筛查标准检测严重ROP患儿的敏感性与特异性分别为37.54%与88.52%,AUC为0.630;《中国早产儿视网膜病变筛查指南(2014年)》筛查严重ROP患儿的敏感性与特异性分别为98.90%与18.40%,AUC为0.587;推荐筛查标准检测严重ROP患儿的敏感性与特异性分别为91.80%与47.00%,AUC为0.694。推荐筛查标准较《中国早产儿视网膜病变筛查指南(2014年)》减少380例(29.5%,380/1286)受检者,仅7例(2.4%,7/293)严重ROP患儿漏诊。结论简化版G-ROP筛查标准对严重ROP检测的准确性欠佳。将筛查标准调整为BW≤1500 g,或GA≤30周更适合我国ROP的筛查策略。

湖北省襄阳地区早产儿视网膜病变认知调查

目的 分析湖北省襄阳地区新生儿重症监护病房(NICU)及产科医护人员、早产儿家长对早产儿视网膜病变(ROP)的认知情况。方法 本研究采用问卷调查方法选择2020年10月—2022年10月在湖北省襄阳市中心医院眼科行ROP筛查的115名早产儿家长及85名襄阳地区新生儿重症监护病房(NICU)人员和产科医护人员为研究对象。记录早产儿基本情况,采用调查问卷对新生儿家长、NICU人员及产科医护人员关于ROP相关知识的认知情况进行调查,并记录调查结果。结果 本研究家长版调查问卷共回收有效问卷115份。54位家长(46.96%)听说过ROP,61位家长(53.04%)未听说过ROP。在所有听说过ROP的早产儿家长中,10位家长(18.52%)通过网上查询或朋友得知,41位家长(75.93%)通过NCIU医生得知,分别有1位(1.85%)通过NCIU护士、产科医生、产科护士告知得知,家长ROP听说途径情况比较,差异有统计学意义(χ^(2)=122.709,P<0.001)。医护人员调查问卷共回收有效问卷95份,仅有7名医护人员可正确写出ROP筛查标准,且均为NICU医生。NICU医生对早产儿家长ROP告知率高于NICU护士、产科医生、产科护士,差异有统计学意义(P<0.05)。结论 湖北省襄阳地区进行ROP筛查的早产儿的家长对ROP相关知识的了解十分欠缺,学历水平是早产儿家长了解ROP相关知识的重要影响因素。相关科室医护人员也应加强ROP相关知识的学习,NICU医生对于ROP宣传具有最重要作用,应重点加强ROP相关知识的宣传力度。

眼底成像系统筛查15283例新生儿眼底病的临床分析

目的:探讨阜阳市颍州区新生儿眼底疾病的检出率和影响因素。方法:选取进行眼底病变筛查的新生儿15283名作为研究对象,根据胎龄分为足月组11692名和早产组3591名。比较2组新生儿眼底疾病的检出率,分析新生儿视网膜出血的影响因素。结果:2组新生儿眼底疾病总检出率差异有统计学意义(P<0.01)。2组检出率最高的眼底疾病类型均为视网膜出血,2组检出率差异有统计学意义(P<0.01)。单因素和多因素logistic回归分析显示,出生胎龄、分娩方式、出生体质量和母亲妊娠期并发症均为新生儿发生视网膜出血的影响因素(P<0.05~P<0.01)。不同出生胎龄、出生体质量新生儿的早产儿视网膜病变检出率差异均有统计学意义(P<0.01)。结论:阜阳市颍州区新生儿视网膜出血等眼底疾病检出率较高,出生胎龄、分娩方式、出生体质量和母亲妊娠期并发症均为新生儿发生视网膜出血的独立影响因素。

深度学习算法在早产儿视网膜病变筛查诊断中的应用进展

早产儿视网膜病变(retinopathy of prematurity,ROP)是早产儿和低体重儿的一种病理性血管增生性疾病,且是儿童致盲的首位因素。因此,对早产儿进行视网膜病变筛查并及时干预至关重要。目前,深度学习在医学图像分析领域逐渐取得新的突破,展现出其巨大的应用潜力,为提高早产儿视网膜病变的诊断效率和准确性提供了新的可能性。深度学习通过端对端的方式可有效地提高对医学图像分类性能,从而辅助儿科医师对早产儿视网膜病变进行精准高效的诊断。在早产儿视网膜病变的诊断中,深度学习可应用于疾病的诊断和严重程度的定量评估,通过训练深度学习模型可实现对病变的精准识别和定位,为临床医生提供更全面的诊断信息,提高诊疗水平。这种技术不仅可以减轻儿科医师的工作压力,还可提高诊断的准确性和效率,为患儿提供更好的治疗方案。深度学习与早产儿视网膜病变图像分析相结合,能在保障一定准确性的同时提高此病的筛查效率,降低筛查成本。本文就深度学习在早产儿视网膜附加病变诊断、分期检测、分区检测和严重程度定量评估等方面的应用进行综述,旨在为早产儿视网膜病变的智能诊断与治疗提供参考,为后续进一步的应用研究提供思路。

双目间接检眼镜在基层医院早产儿视网膜病变筛查中的应用

目的分析双目间接检眼镜在基层医院早产儿视网膜病变筛查中的应用价值。方法选取2018年5月—2022年5月莆田学院附属医院的409例早产儿为研究对象,对所有早产儿应用双目间接检眼镜筛查其视网膜情况,并将最终的临床诊断结果作为“金标准”,统计分析双目间接检眼镜筛查早产儿视网膜病变的符合情况,并对双目间接检眼镜筛查早产儿视网膜病变的特异性、灵敏度进行计算。结果409例早产儿最终经“金标准”诊断有72例、72眼视网膜病,视网膜病变率为17.60%。其中,视网膜病变Ⅲ区Ⅰ期者8例8眼,Ⅲ区Ⅱ期者2例2眼,Ⅲ区Ⅲ期者4例4眼,无Ⅳ期或Ⅴ期病变。本次双目间接检眼镜筛查共计检出74例视网膜病变,双目间接检眼镜筛查符合率为95.60%(391/409),筛查特异性为97.03%(327/337),筛查灵敏度为88.89%(64/72)。双目间接检眼镜具有较高的筛查准确率,与“金标准”相比,在视网膜病变诊断及视网膜病变分类的筛查中数据差异无统计学意义(P>0.05)。检查期间发现有2例早产儿头皮下存在较多的出血点,2例2眼有不同程度的急性结膜炎,7例7眼存在一定的球结膜下出血。45例患儿家属诉患儿筛查后睡觉时常有惊叫。检查后没有出现休克、呼吸暂停等严重并发症。结论双目间接检眼镜在基层医院早产儿视网膜病变筛查中具有良好的应用效果,能够较为准确的筛查视网膜病变以及对病变进行分型。