Preliminary results of screening for retinopathy of prematurity at different altitudes in Yunnan Province_Chinese Journal of Ocular Fundus Diseases

Authors：

Lu Jun ¹ , Li Xiaoqin ¹ , Li Jia ¹ , Yin Zhaoqing ² , Wan Jing ² ,  Li Na ¹

1. Department of Ophthalmology, Kunming Maternal and Child Health Hospital, Kunming 650031, China;
2. Department of Neonatology, Dehong Dai Jingpo Autonomous Prefecture People's Hospital, Mangshi 678400, China;

Corresponding author：

Li Na, Email: done23@qq.com

Keywords：

Premature infants; Retinopathy of prematurity; Incidence rate; High altitude areas; Low altitude area

DOI：

10.3760/cma.j.cn511434-20240802-00296

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Objective To observe the incidence of retinopathy of prematurity (ROP) at different altitudes in Yunnan Province. Methods A retrospective case-control study. From July 1, 2010 to June 30, 2019, 1 352 premature infants (Kunming group) and 579 premature (Dehong group) infants who received ROP screening in the Neonatology Department of Kunming Maternal and Child Health Hospital and the Neonatology Department of Dehong Dai and Jingpo Autonomous Prefecture People's Hospital were included in the study. A wide field digital retinal imaging system combined with binocular indirect ophthalmoscope and scleral oppressor was used for fundus examination. Inspection results were recorded according to the international ROP classification. The incidence of ROP in recent 10 years was retrospectively analyzed. Independent sample t test was used for comparison between groups. Results Among the 1 352 preterm infants in Kunming group, 716 were males and 636 were females. The birth weight was (1 765.75±357.64) g; gestational age of birth were (32.51±2.07) weeks. The altitude of the residence was (1 920±30) m. Among 579 premature infants in Dehong group, 302 were males and 277 were females. The birth weight was (1 762.54±401.73) g; gestational age of birth were (32.10±2.36) weeks. The altitude of the residence was (920±80) m. There was no significant difference in sex composition ratio (χ²=0.10, P=0.75) and birth weight (t=0.17, P=0.87) between the two groups (P≥0.05). Gestational age and elevation of residence were compared, and the difference was statistically significant (t=3.82, 35.15; P＜0.01). ROP was detected in 72 cases 144 eyes (5.32%, 72/1 352) in Kunming group and 55 cases 110 eyes (9.5%, 55/579) in Dehong group. Both cases were binocular. There was significant difference in the detection rate of ROP between the two groups (χ²=11.49, P＜0.01). ROP stages 1 to 3 in Kunming and Dehong groups were 128 (88.89%, 128/144), 6 (4.17%, 6/144), 6 (4.17%, 6/144) eyes and 18 (16.36%, 18/110), 66 (60.00%, 66/110), 22 (20.00%, 22/110) eyes. The acute ROP (A-ROP) was 4 (2.78, 4/144) and 4 (3.63%, 4/110) eyes in Kunming and Dehong groups, respectively. There were significant differences in the detection rates of ROP in stages 1 to 3 between the two groups (χ²=11.26, 66.48, 15.86, 0.76; P＜0.05). There was no significant difference in the detection rate of A-ROP (χ²=0.76, P＞0.05). Conclusion The detection rate of ROP in high altitude area of Yunnan Province is significantly lower than that in low altitude area.

Citation： Lu Jun, Li Xiaoqin, Li Jia, Yin Zhaoqing, Wan Jing, Li Na. Preliminary results of screening for retinopathy of prematurity at different altitudes in Yunnan Province. Chinese Journal of Ocular Fundus Diseases, 2024, 40(12): 936-940. doi: 10.3760/cma.j.cn511434-20240802-00296 Copy

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1. 中华医学会眼科学分会眼底病学组, 中国医师协会眼科医师分会眼底病专委会. 中国早产儿视网膜病变分类和治疗专家共识(2023年)[J]. 中华眼底病杂志, 2023, 39(9): 720-727. DOI: 10.3760/cma.j.cn511434-20230815-00346.Fundus Disease Group of Ophthalmological Society of Chinese Medical Association, Fundus Disease Group ofOphthalmologist Branch of Chinese Medical Doctor Association. Expert consensus on the classification and treatment of retinopathy of prematurity in China (2023)[J]. Chin J Ocul Fundus Dis, 2023, 39(9): 720-727. DOI: 10.3760/cma.j.cn511434-20230815-00346.
2. Hellström A, Smith LE, Dammann O. Retinopathy of prematurity[J]. Lancet, 2013, 382(9902): 1445-1457. DOI: 10.1016/S0140-6736(13)60178-6.
3. 李丽红, 李娜, 卢军, 等. 昆明市妇幼保健院新生儿眼病筛查4年回顾[J]. 中国妇幼保健, 2015, 30(18): 2986-2990. DOI: 10.7620/zgfybj.j.issn.1001-4411.2015.18.33.Li LH, Li N, Lu J, et al. A 4-year retrospective study on neonatal eye disease screening in Kunming Maternal and Infant Health Care Hospital[J]. Chinese Maternal and Child Health Care, 2015, 30(18): 2986-2990. DOI: 10.7620/zgfybj.j.issn.1001-4411.2015.18.33.
4. 《中华儿科杂志》编辑委员会, 中华医学会儿科学分会新生儿学组. 早产儿管理指南[J]. 中华儿科杂志, 2006, 44(3): 188-191. DOI: 10.3760/cma.j.issn.0578-1310.2006.03.109.Editorial Board of the Chinese Journal of Pediatrics, Neonatology Group of the Pediatric Branch of the Chinese Medical Association. Guidelines for the management of preterm infants[J]. Chin J Pediatr, 2006, 44(3): 188-191. DOI: 10.3760/cma.j.issn.0578-1310.2006.03.109.
5. 朱雪梅, 斯娜卓嘎, 周永康, 等. 西藏拉萨早产儿视网膜病变筛查的初步结果[J]. 中华眼底病杂志, 2023, 39(1): 59-61. DOI: 10.3760/cma.j.cn511434-20220524-00320.Zhu XM, Si NGZ, Zhou YK, et al. Preliminary results of retinopathy of prematurity screening in preterm infants in Lhasa, Tibet[J]. Chin J Ocul Fundus Dis, 2023, 39(1): 59-61. DOI: 10.3760/cma.j.cn511434-20220524-00320.
6. 马学仁, 张琼, 康宏, 等. 青海省310例早产儿视网膜病变筛查结果及其危险因素分析[J]. 中华眼底病杂志, 2017, 33(6): 631-632. DOI: 10.3760/cma.j.issn.1005-1015.2017.06.018.Ma XR, Zhang Q, Kang H, et al. Analysis of screening results and risk factors for retinopathy of prematurity in 310 preterm infants in Qinghai province[J]. Chin J Ocul Fundus Dis, 2017, 33(6): 631-632. DOI: 10.3760/cma.j.issn.1005-1015.2017.06.018.
7. 中国医师协会新生儿科医师分会. 早产儿治疗用氧和视网膜病变防治指南(修订版)[J]. 中华实用儿科临床杂志, 2013, 28(23): 1835-1836. DOI: 10.3760/cma.j.issn.2095-4428X.2013.23.023.Chinese Medical Doctor Association Branch of Neonatologists. Guidelines for the treatment of preterm infants with oxygen and prevention of retinopathy of prematurity (revised edition)[J]. Chin J Appl Clin Pediatr, 2013, 28(23): 1835-1836. DOI: 10.3760/cma.j.issn.2095-428X.2013.23.023. DOI: 10.3760/cma.j.issn.2095-4428X.2013.23.023.
8. Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of respiratory distress syndrome-2016 update[J]. Neonatology, 2017, 111(2): 107-125. DOI: 10.1159/000448985.
9. 中华医学会眼科学分会眼底病学组. 中国早产儿视网膜病变筛查指南(2014年)[J]. 中华眼科杂志, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.Ophthalmology Group of Ophthalmology Society of Chinese Medical Association. Guidelines for screening of retinopathy of prematurity in preterm infants (2014)[J]. Chin J Ophthalmol, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.
10. International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited[J]. Arch Ophthalmol, 2005, 123(7): 991-999. DOI: 10.1001/archopht.123.7.991.
11. 杜婉丽, 张瑜, 范真. 早产儿视网膜病变筛查结果分析[J]. 中国斜视与小儿眼科杂志, 2012, 20(1): 11-13. DOI: 10.3969/j.issn.1005-328X.2012.01.004.Du WL, Zhang Y, Fan Z. The analysis on the result of retinopathy of prematurity screening[J]. Chinese Journal of Strabismus & Pediatric Ophthalmology, 2012, 20(1): 11-13. DOI: 10.3969/j.issn.1005-328X.2012.01.004.
12. Seiberth V, Linderkamp O. Risk factors in retinopathy of prematurity. a multivariate statistical analysis[J]. Ophthalmologica, 2000, 214(2): 131-135. DOI: 10.1159/000027482.
13. Kim SJ, Port AD, Swan R, et al. Retinopathy of prematurity: a review of risk factors and their clinical significance[J]. Surv Ophthalmol, 2018, 63(5): 618-637. DOI: 10.1155/2013/728195.
14. 金顺祥, 许江涛, 肖亦爽, 等. 昆明市儿童医院1010例早产儿或低体重儿早产儿视网膜病变发病率及其影响因素分析[J]. 中华眼底病杂志, 2016, 32(3): 314-316. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.022.Jin SX, Xu JT, Xiao YS, et al. Analysis of prevalence and influencing factors of retinopathy of prematurity in preterm or low-birth-weight infants: a study of 1010 cases at children's hospital of Kunming city[J]. Chin J Ocul Fundus Dis, 2016, 32(3): 314-316. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.022.
15. 李颖洁, 刘维锋, 肖国蓓, 等. 早产儿视网膜病变筛查的初步分析[J]. 中华眼底病杂志, 2014, 30(1): 88-90. DOI: 10.3760/cma.j.issn.1005-1015.2014.01.024.Li YJ, Liu WF, Xiao GB, et al. Preliminary analysis of retinopathy of prematurity screening in preterm infants[J]. Chin J Ocul Fundus Dis, 2014, 30(1): 88-90. DOI: 10.3760/cma.j.issn.1005-1015.2014.01.024.
16. 张国明, 曾键, 黄丽娜, 等. 深圳早产儿视网膜病变筛查结果分析[J]. 中华眼底病杂志, 2008, 24(1): 38-40.Zhang GM, Zeng J, Huang LN, et al. Screening results of retinopathy of prematurity in preterm infants in 3 hospitals in Shenzhen[J]. Chin J Ocul Fundus Dis, 2008, 24(1): 38-40.
17. 郭宝, 张德勇, 蔡文茜, 等. 徐州地区早产儿视网膜病变相关因素分析[J]. 中国斜视与小儿眼科杂志, 2014, 22(2): 16-18.Guo B, Zhang DY, Cai WQ, et al. Analysis of related factors of retinopathy of prematurity in Xuzhou area[J]. Chinese Journal of Strabismus & Pediatric Ophthalmology, 2014, 22(2): 16-18.
18. 李秋平, 王宗华, 李耀宇, 等. 早产儿视网膜病变筛查分析[J]. 中华眼科杂志, 2012, 48(10): 903-907. DOI: 10.3760/cma.j.issn.0412-4081.2012.10.010.Li QP, Wang ZH, Li YY, et al. Analysis of retinopathy of prematurity screening in preterm infants[J]. Chin J Ophthalmol, 2012, 48(10): 903-907. DOI: 10.3760/cma.j.issn.0412-4081.2012.10.010.
19. 王雨生, 张自峰, 李曼红, 等. 西安地区早产儿视网膜病变筛查的初步结果[J]. 中华眼科杂志, 2010, 46(2): 119-124. DOI: 10.3760/cma.j.issn.0412-4081.2010.02.006.Wang YS, Zhang ZF, Li MH, et al. Preliminary results of retinopathy of prematurity screening in preterm infants in Xi'an area[J]. Chin J Ophthalmol, 2010, 46(2): 119-124. DOI: 10.3760/cma.j.issn.0412-4081.2010.02.006.
20. Yu CW, Popovic MM, Dhoot AS, et al. Demographic risk factors of retinopathy of prematurity: a systematic review of population-based studies[J]. Neonatology, 2022, 119(2): 151-163. DOI: 10.1159/000519635.
21. Vij AG, Dutta R, Satija NK. Acclimatization to oxidative stress at high altitude[J]. High Alt Med Biol, 2005, 6(4): 301-310. DOI: 10.1089/ham.2005.6.301.
22. 刘娟丽, 马四清, 乌仁塔娜. 高海拔低氧对孕期胎儿发育的影响及原因分析[J]. 生理学报, 2017, 69(2): 235-239. DOI: 10.13294/j.aps.2017.0010.Liu JL, Ma SQ, Wu RTN. Effect of high altitude hypoxia on fetal development during pregnancy and the reason analysis[J]. Acta Physiologica Sinica, 2017, 69(2): 235-239. DOI: 10.13294/j.aps.2017.0010.
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Chinese Journal of Ocular Fundus Diseases

Preliminary results of screening for retinopathy of prematurity at different altitudes in Yunnan Province

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