内蒙古包头地区4 016例新生儿应用Retcam 3眼底筛查结果分析

目的：探讨广域数字儿童视网膜成像系统Retcam 3（简称Retcam 3）在足月新生儿眼底筛查中应用的技术价值，同时分析新生儿眼底病变及相关影响因素。方法：回顾性研究。收集2015年9月至2017年2 月在包钢集团第三职工医院眼科应用Retcam 3 行眼底检查的4 016 例足月新生儿的临床病历资料。采用相对数指标对计数资料进行统计描述，蒙古族和汉族组间视网膜出血阳性率的比较采用卡方检验进行数据分析。结果：接受眼底筛查的4 016 例足月新生儿中，1 438 例检查出眼底病变（阳性率为35.81％）。其中视网膜出血1 317 例（32.79％），单眼视网膜出血833 例（20.74％），双眼视网膜出血484例（12.05％）。Ⅰ级视网膜出血单眼412例（10.26％），双眼148例（3.68％）；Ⅱ级视网膜出血单眼304 例（7.57％），双眼239 例（5.95％）；Ⅲ级视网膜出血单眼101 例（2.51％），双眼84 例（2.09％）；Ⅳ级视网膜出血单眼16例（0.40％），双眼13例（0.32％）。视网膜白点症36例（0.90％），其中单眼30例（0.74％），双眼6例（0.15％）。视网膜色素痣25例（0.62％），其中单眼24例（0.60％），双眼1例（0.02％）。脉络膜缺损（均未合并虹膜缺损） 5 例（0.12％），视网膜色素分布不均10 例（0.25％），可疑家族性渗出性玻璃体视网膜病变（均未做眼底荧光素血管造影和基因检测）24 例（0.60％），视网膜血管异常14例（0.35％），视网膜前出血2例（0.04％），玻璃体出血1例（0.02％），白化病眼底改变2例（0.04％），先天性白内障2例（0.04％）。结论：Retcam 3广域眼底成像系统可及时发现新生儿眼部病变，为临床干预诊疗提供可靠有效的客观依据。新生儿眼底病变类型多样，患病率较高，应加强筛查力度。

Results of an Analysis of Retcam 3 Eyeground Screening of 4 016 Newborns in Baotou,Inner Mongolia

Objective: To use the Retcam 3 for neonatal eye screening to assess its technological value, and to simultaneously analyze the fundus pathological changes and related factors in neonates. Methods: This was a retrospective analysis of the clinical medical records of 4 016 full-term newborns whose fundus had been examined from September 2015 to February 2017 with a Retcam 3 imaging system in NO.3 Bao Gang Workers' Hospital. A relative number index was used to describe the enumerated data, and a chi square test was used for analysis. Results: 1 438 cases of fundus lesions (positive rate of 35.81%) were discovered in4 016 newborns who had undergone a fundus screening check. There were 1 317 cases of retinal bleeding(20.74% and 12.05% for monocular and binocular, respectively), 36 cases of white spots in the retina (0.90%, 0.74% and 0.15% for monocular and binocular), 25 cases of retinal pigment nevi (0.62%, 0.60% and 0.02% for monocular and binocular), 5 cases of choroidal coloboma (0.12%) that was not combinedwith collyriculum iridis, 10 cases of uneven distribution of retinal pigment (0.25%), 24 cases (0.60%) of suspected familial exudative vitreoretionpathy without fundus fluorescene angiography and gene detection,14 cases of retinal vascular exception (0.35%), 2 cases of preretinal hemorrhage (0.04%), 1 case of vitreous bleeding (0.02%), 2 cases of albinism with fundus changes (0.04%) and 2 cases of congenital cataract (0.04%). In detail, the cases of levels Ⅰ, Ⅱ, Ⅲ and Ⅳ of retinal bleeding were 560 (10.26% and 3.68% for monocular and binocular), 543 (7.57% and 5.95% for monocular and binocular), 185 (2.51% and 2.09% for monocular and binocular) and 29 (0.40% and 0.32% for monocular and binocular), respectively.Conclusions: The Retcam 3 wide-field fundus imaging system can detect eye disease in neonates, providing a reliable and effective basis for clinical diagnosis and treatment. Fundus lesions in neonates are diverse with a high detection rate. It should be taken into account by the parents of newborns and society.