早产儿眼病的两种筛查模式效果评价

目的：探讨并对比两种筛查模式在检查早产儿视网膜病变(retinopathy of prematurity，ROP)中的应用情况。

方法：回顾性分析2016-01/2017-01我院眼科行眼病筛查的600例1 200眼早产儿病例资料，均采用双眼间接检眼镜(binocular indirect ophthalmoscope，BIO)和第3代广角数码视网膜成像系统(RetCam Ⅲ)检查眼底病变，统计检查结果及操作过程中出现的不良事件。

结果：患者600例1 200眼中，BIO检出ROP的几率为10.92%，与RetCam Ⅲ(10.75%)比较，差异无统计学意义(P>0.05)； 以BIO为“金标准”，RetCam Ⅲ检查ROP的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为98.67%、93.13%、99.35%、94.57%、99.16%。BIO、RetCam Ⅲ检查ROP分期结果比较，差异无统计学意义(P>0.05)。BIO检查眼底非ROP病变的几率为4.83%，与RetCam Ⅲ(4.58%)比较，差异无统计学意义(P>0.05)； 以BIO为“金标准”，RetCam Ⅲ检查眼底非ROP病变的准确性、敏感性、特异性、阳性预测值、阴性预测值分别为99.67%、94.83%、99.91%、98.21%、99.74%。BIO筛查过程中17例(2.83%)出现不良事件，与RetCam Ⅲ的7例(1.17%)比较，差异有统计学意义(P<0.05)。

结论：RetCam Ⅲ检查ROP及早产儿眼底非ROP病变结果与BIO基本一致，但在减少操作过程中的不良事件上RetCam Ⅲ更具优势。

Effects of two screening models for eye diseases in premature infants

AIM:To investigate and compare the application of two screening models in the detection of retinopathy of prematurity(ROP).

METHODS: The clinical data of 600 premature infants(1200 eyes)who underwent screening of eye diseases in the Department of Ophthalmology during the period from January 2016 to January 2017 were analyzed retrospectively. The fundus lesions were examined with binocular indirect ophthalmoscope(BIO)and the third generation of wide-angle digital retinal imaging system(RetCam III). The examination results and adverse events during operation were statistically analyzed.

RESULTS: In 1200 eyes of 600 patients, the probabilities of ROP detected by BIO and RetCam III were 10.92% and 10.75%, respectively(P>0.05). With BIO as the golden standard, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of RetCam III in examining ROP were 98.67%, 93.13%, 99.35%, 94.57% and 99.16%, respectively. There was no significant difference in the stage of ROP detected by BIO or RetCam III(P>0.05). The probabilities of non-ROP lesions examined by BIO and RetCam III were 4.83% and 4.58%, respectively(P>0.05). With BIO as the golden standard, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of RetCam III in examining fundus non-ROP diseases were 99.67%, 94.83%, 99.91%, 98.21% and 99.74%, respectively. During the screening of BIO and RetCam III, there were 17 cases(2.83%)and 7 cases(1.17%)with adverse events, respectively(P<0.05).

CONCLUSION: The examination results of RetCam III are basically the same as those of BIO for ROP and non-ROP diseases. However, RetCam III has more advantages in reducing adverse events during operation.