Retinopathy in premature infants

Retinopathy of prematurity (ROP) is found in about 30% of premature infants with a birth weight < 1500 g and/or a gestational age < 32 weeks. Many risk factors are directly or indirectly involved in the development of ROP. The younger the child and therefore the more immature at birth, the greater the risk of ROP leading to short-sightedness or blindness. As a result of advances in obstetric and neonatal care, more immature and extremely low birth weight infants survive, and thorough ophthalmological screening for ROP is therefore essential. Timely detection (ROP stage 3) enables treatment with cryotherapy or laser therapy. Although the rate of success has increased with these forms of treatment, about 40% of the treated children retain a serious visual handicap. In the Netherlands, this involves about 10 children each year. At a later age, prematurely born children have a higher risk of developing other ophthalmologic problems such as strabismus, amblyopia and refractive errors. Again, timely detection and treatment reduces the risk of permanent visual disability.     

Diabetic Retinopathy Screening

As part of the Institute of Medical Illustrators' (IMI) scheme for continuing professional development (CPD), worksheets will be published at regular intervals in this Journal. These are designed to provide the members of IMI with a structured CPD activity that offers one way to earn credits. It is recognized that this worksheet requires some time spent obtaining and reading a number of publications. As a way of ensuring that the allocated time has been spent on the activities a number of self-assessment exercises (SAEs) have been included. Upon completion of this worksheet, you will be credited with 10 CPD points. The answers to the SAEs, along with any notes you make and other publications you find, should be kept in your CPD portfolio.     

Issues in Management of Diabetic Retinopathy

Panretinal photocoagulation could prevent most blindness from proliferative disease—if risk is identified early. This makes it essential that primary physicians include annual ophthalmologic evaluation in the management of patients at risk. Meanwhile, studies are under way on promising medical approaches, including intensive insulin regimens, aldose reductase blockers, and angiogenesis inhibitors.     

在社区进行近视眼视网膜病变筛查的价值评估

我国是世界上近视眼发病率高的国家之一。近视眼具有产生视网膜变性、裂孔和视网膜脱离的倾向,这与眼轴的延长、眼球赤道部直径的增大、视网膜牵拉变薄有关。严重损害了患者的视功能,降低了近视患者的生活质量。我们于2007年1—12月对我市部分社区的近视眼患者进行了眼底病变的筛查,并分析和总结了筛查资料,对该项工作的价值进行了评估,现报告如下。     

Current Concepts in Treatment of Diabetic Retinopathy

A growing problem, retinopathy is an almost inevitable complication of diabetes of long standing and is not preventable even through good control of blood sugar. But its sight-threatening progression can be followed and its course ameliorated in many patients by such modalities as photocoagulation or pituitary ablation, or sometimes both. Guidelines to diagnosis and management are detailed.     

早产儿视网膜病筛查的护理管理

目的探讨早产儿视网膜病变筛查中护理管理的方法。方法743例早产儿由医生使用计算机辅助双目间接检眼镜系统进行视网膜病变筛查,护士为患儿实施检查前、中、后的全面护理管理。结果所有早产儿均安全、顺利地完成视网膜眼底检查。结论因为早产儿组织器官发育不成熟、功能不全、抵抗力差,完成视网膜检查过程需要护士为患儿进行全方位的护理管理,以保证检查的顺利完成。     

早产儿视网膜病筛查的护理管理

目的探讨早产儿视网膜病变筛查中护理管理的方法。方法743例早产儿由医生使用计算机辅助双目间接检眼镜系统进行视网膜病变筛查,护士为患儿实施检查前、中、后的全面护理管理。结果所有早产儿均安全、顺利地完成视网膜眼底检查。结论因为早产儿组织器官发育不成熟、功能不全、抵抗力差,完成视网膜检查过程需要护士为患儿进行全方位的护理管理,以保证检查的顺利完成。     

Telemedicine Screening for Diabetic Retinopathy

Diabetic eye disease is the most common cause of new cases of blindness in the Western world. If the disease is detected early then proper treatment can be provided to prevent loss of vision. Regular screening can reduce the incidence and prevalence of blindness due to diabetic retinopathy. Health personnel, optometrists and primary care providers can perform the screening using digital nonmydriatic fundus cameras. Digital data can be archived, stored, manipulated and sent via telecommunication networks, e.g. the Internet, to ophthalmologists for diagnosis and second opinions.Easy-to-operate, low cost and portable digital fundus cameras and intuitive software are necessary to perform cost-effective screening of rural, remote and underserved communities using trained lay personnel. Several feasibility studies of telemedicine screening for diabetic retinopathy have been reported. These studies demonstrate the enormous usefulness of this technology for communities living in rural and remote areas. Further studies are needed to prove the cost benefit of telemedicine technology for diabetic retinopathy screening.     

HGF在2型糖尿病大鼠视网膜病变中的变化及意义

目的探讨肝细胞生长因子(Hepatocyte Growth Factor HGF)在糖尿病视网膜病变(Diabetic Retinopathy,DR)发生发展中的作用。方法雄性Wistar大鼠70只,随机分为实验组和对照组:实验组大鼠40只,喂以高糖高脂饲料2月后,腹腔注射链脲佐菌素(STZ)30 mg/kg;对照组大鼠30只,喂以普通饲料2月后,腹腔注射等体积的枸橼酸缓冲液。两组分别于注射前、注射后1月、2月、3月和6月每组各处死6只,取血测定血清HGF、胰岛素水平,并制备视网膜病理及电镜切片。结果实验组大鼠血HGF于注射STZ 1月后即明显增高,至2月时达最高值,以后逐渐降低,但始终高于对照组(P<0.01)。结论实验组大鼠血清HGF水平显著高于对照组,提示HGF可能参与了DR的发生发展。     

早产儿视网膜病变的最新研究进展

早产儿视网膜病变(ROP)是指枧网膜血管的异常增殖性疾病,是儿童致盲的主要原因.早产儿视网膜血管发育不完善是其根本原因.现就近年对ROP发病率、病因、发病机制、诊断及治疗等方面的最新研究进展进行综述,以提高对本病的认识,从而降低ROP发生率,改善儿童生存质量.     

早产儿视网膜病的治疗进展

早产儿视网膜病(retinopathy of prematurity,ROP)是当今世界范围内儿童致盲的首要因素。随着早产儿存活率的增加,早产儿视网膜病的发病率及致残率也逐年上升,但现有的治疗方法不能对其进行早期有效干预和治疗,而一些新的研究进展,则为早产儿视网膜病的药物治疗提供了新思路。本文就新近发现的靶向药物(血管内皮生长因子、胰岛素样生长因子-1和多聚不饱和脂肪酸)在治疗早产儿视网膜病的机制和应用上进行综述如下。     

早产儿视网膜病变的筛查分析

目的探讨早产儿视网膜病变(ROP)的临床特点。 方法选择2010年7月8日至2012年9月6日在成都市妇女儿童中心医院新生儿科实业街分部收治的93例接受ROP筛查的早产儿、低出生体重(LBW)儿为研究对象。其中,男性为48例,女性为45例,平均出生体重为（1547 ± 345）g,胎龄为(27~ 36)孕周,平均为(31±2)孕周（本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并征得患儿家属的知情同意）。回顾性分析其ROP的临床特点。 结果93例接受ROP筛查的儿童中,10例出现ROP,发病率为10.75%。体重<1200 g者ROP发病率为3. 23 % (3/93) ,(1200～1700)g为5. 38%(5/93),(1701～2200)g为2. 15% (2/93)。分娩孕龄 ≤30孕周的ROP发病率为4. 30% (4/93),分娩孕周为（31～32）孕周的ROP发病率为6.45 % (6/93）。ROP相关因素的疾病表现为呼吸暂停(χ² = 5. 03,P<0. 05)、新生儿呼吸窘迫综合征(NRDS)(χ² =6. 84,P<0. 05)、新生儿肺炎(χ² = 7. 55,P<0. 05)、病理性黄疸(χ² = 3. 98,P<0. 05)、窒息(χ² = 8. 46 ,P<0. 05)和呼吸机相关性肺炎(VAP) (χ² =3. 56,P< 0.05)。 结论早产儿应及时行规范的眼底检查,对ROP应早发现、早治疗。