早产儿眼病的特征分析

目的分析早产儿眼病特征及其发病情况。方法以562例早产儿为筛查对象，筛查内容包括视觉评估、外眼检查、直接检眼镜和间接检眼镜检查，必要时行视觉诱发电位（VEP）、眼科B型超声、头颅MRI等辅助检查。结果在562例早产儿中，检出眼病11种，共93例（16．5％），其中视网膜脉络膜病变52例（9．8％），包括早产儿视网膜病变（ROP）51例（9．07％）和视网膜出血1例（0．18％）；视神经及视路病变16例（3．02％），包括视盘缺损1例（0．18％）、视神经萎缩6例（1．1％）、视路及视皮质病变9例（1．6％）；眼前节疾病12例（2．14％），包括先天性白内障8例（1．4％）、先天性青光眼2例（0．36％）、先天性虹膜缺损1例（0．18％）、淋球菌性结膜炎1例（0．18％）；外眼病变5例（0．9％），包括新生儿泪囊炎3例（0．54％）、上睑下垂2例（0．36％）；原因不明的视力异常8例。B型超声提示ROP合并视网膜脱离者8例，玻璃体出血者1例。头颅MRI提示缺血缺氧性脑病138例、颅内出血21例、脑积水5例、蛛网膜下腔出血1例、先天性大脑发育不良1例。结论早产儿以ROP、视神经病变、视路及视皮质病变、先天性白内障为主，同时有多种散发的眼科病。常规的早期眼科筛查对早产儿眼病的防治十分必要。

Study on the features of retinopathy of prematurity

Objective The screening of retinopathy of prematurity （ROP） is very important for the early diagnosis and treatment of ROP and preservation of visual function of patients. The aim of this study was to analyze the features and incidence of prematurity ocular diseases. Methods Five hundred and sixty-two cases of prematurity aged from l to 6 months were from different areas of Henan province. The patients were evaluated for mass screening of ocular diseases in Henan Eye Institute from January 1,2005 to December 12,2007. The evaluation items for screen included reflect to light stimulation, external ocular examination and fundus examination. The visual evoked potentials （VEP） , B-scan ultrasonography and magnetic resonance imaging （MRI） were performed in the patients with abnormality during the screen. The history assessment included gestational age, corrective gestational age,gestational period findings, burned state, oxygen uptake state, relevant brain and central nerve system disorders. All the examinations were operated by the trained ophthalmologists. Results Eleven kinds of ocular diseases were detected in 93 of 562 cases of prematurity （ 16.5 % ）, involving retinopathy of prematurity （ROP） in 51 cases （ 9.07% ） , retinal hemorrhage in 1 case（0. 18% ）,coloboma of optic nerve in 1 case（0. 18% ） ,optic atrophy in 6 cases（ 1.06% ）,visual pathway and cortical diseases in 9 cases （ 1.6% ） , congenital cataract in 8 cases （ 1.4% ） , congenital glaucoma in 2 cases （ 0. 36% ） , coloboma of iris in 1 case（0. 18% ） ,gonocoecal conjunctivitis in 1 case（0. 18% ） ,neonatal dacryocystitis in 3 cases（0.54% ） and Ptosis in 2 cases （0. 36% ）. The abnormalities of visual acuity unknown origin were detected in 8 cases. B-type uhrasonography indicated 8 cases of ROP and 1 case of vitreous hemorrhage. MRI demonstrated 138 cases of encephalopathy,21 cases of encephalie hemorrhage, 5 cases of waterhead, 1 case of subarachnoid hemorrhage and 1 cases of congenital cerebra