ABSTRACT
RESUMEN La retinopatía de la prematuridad es la parte de la Oftalmología pediátrica que más interés suscita en la actualidad. En las últimas dos décadas, se realizaron rigurosos trabajos de investigación clínica sobre esta temática pues es la causa más frecuente de ceguera infantil en países desarrollados. Dicha afección fue descrita por primera vez por Terry en 1940 como fibroplasia retrolental, forma cicatricial de la enfermedad. En la década de los 50 se relacionó con el aporte elevado e incontrolado de oxígeno, lo que llevó a un control estricto de este y a restringir su uso en las Unidades de Neonatología. La Clasificación Internacional de la Retinopatía de la Prematuridad describió sus grados de gravedad basándose en cuatro parámetros: localización, estadio, extensión y presencia de enfermedad plus. El personal médico y paramédico de las salas de terapias intensivas neonatales se ha preparado para disminuir la incidencia de esta enfermedad.
ABSTRACT Retinopathy of prematurity is the part of Pediatric Ophthalmology that arouses the most interest today. In the last two decades, rigorous clinical research has been carried out on this subject, as it is the most common cause of childhood blindness in developed countries. This condition was first described by Terry in 1940 as retrolental fibroplasia, a scar form of the disease. In the 1950s, it was related to a high and uncontrolled oxygen supply, which led to its strict control, as well as to restrict its use in the Neonatology units. The International Classification of Retinopathy of Prematurity described its degrees of severity based on four parameters: location, stage, extension and presence of plus disease. Medical and paramedical personnel of the neonatal intensive care units have been prepared to reduce the incidence of this disease.
Subject(s)
Retinopathy of Prematurity/diagnosisABSTRACT
Early detection and timely treatment hold the key to cure retinopathy of prematurity (ROP).ROP screening is carried out unevenly in China.Examination equipments and personnel experiences are the major factors to constraint ROP screening.In addition to strengthening personnel training,it is necessary to establish a standard guideline and pipeline for ROP consultation and referral. Laser photocoagulation and cryotherapy are the first options for the threshold ROP and Type 1 pre-threshold ROP.Scleral buckling or vitrectomy is needed for advanced ROP when retinal detachment occurs. The clinical efficacy of intravitreal injection of bevacizumab (an anti-vascular endothelial growth factor monoclonal antibody) for severe ROP is encouraging,but needs further verification.Genetic interference and stem cell therapy will be the prosperous futures in the treatment of ROP.The screening and treatment of ROP in China is becoming more common and improved,but it is still a long way to go considering the huge population of China.
ABSTRACT
Objective To investigate the degree of retinal development in preterm infants. Methods Flash electroretinography (ERG) was performed on 25 healthy preterm infants and 25 full-term ones, and the response of rod cells and cone cells and maximal mixed responses were recorded. The delitescence and amplitudes of a- and b-waves and the ratio of amplitudes of b-/a-wave of maximal responses were analyzed. Results Compared with the full-term infants, The delitescence of responses of rod cells in preterm infants was statistically longer (.t=11.007,P.=0.000) but without any significant changes of amplitudes (.t=1.836,P.=0.069); statistically longer delitescence (.t=2.44, P=0.010; (t=10.800,)P.=0.000) and lower amplitude (.t=5.804,P=0.000; t=5.809,P.=0.000) of a- and b-wave of maximal response were found in preterm infants group. In the response of cone cells, there were significant differences of the delitescence (.t=4.444,P.=0.000) and amplitude (.t=3.819,P.=0.000)of a-wave and delitescence of b-wave(.t=2.850,P.=0.005) between the two groups, and no statistical difference of amplitude of b-wave (.t=0.486,P.=0.628) between the two groups. The ratio of amplitudes of b-/a-wave of the maximal mixed response was not significantly different between the two groups ((.t=1.142,)P.=0.256). Conclusions The development of retinal function is slower in preterm infants than that in full-term ones.