Objective To observe the factors influencing for results of laser treatment of zone one retinopathy of premature（ROP）. Methods The clinical data of 35 patients（69 eyes）with ROP in zone one who diagnosed by examination of indirect ophthalmoscopy were retrospectively analyzed. The eyes were divided into anterior zone one（49 eyes ）and posterior zone one（20 eyes）. The 69 eyes, aggressive posterior ROP（AP-ROP）in 12 eyes, anterior zone one in four eyes and posterior zone one in eight eyes. The laser photocoagulation of diode indirect ophthalmoscopy with +20 D lens and sclera compressor were used to entire avascular retina. Followup ranged from two to 48 months with the mean of (10.85plusmn;11.35 )months. Take the cristae fadeaway and stable condition as cure; retinopathy proceed to the stage 4 and 5 ROP as retinopathy progress. Results Forty-two out of 69 eyes (60.87%) were cured and retinopathy progress in 27 eyes (39.13%). Thirty-four out of 49 eyes (69.38%) with anterior zone one were cured and retinopathy progress in 15 eyes (30.61%); eight out of 20 eyes (40.00%) with posterior zone one were cured and retinopathy progress in 12 eyes (60.00%). The difference of progress rate between anterior and posterior zone one was statistically significant（chi;2=5.15, P＜0.05).Conclusions Laser photocoagulation is effective for treatment of zone one ROP, the prognosis of anterior zone one is better than posterior zone one; retinopathy progress after photocoagulation was associated with extent of fibrovascular organization.
早产儿视网膜病变（ROP）是儿童盲的重要致盲原因之一，随着ROP防治指南的颁布以及ROP筛查工作的开展，我国ROP发病率和致盲率有所下降。正确认识和理解ROP分类、筛查标准和治疗指南；建立完善的ROP筛查体系，提高筛查水平；加强ROP临床和基础研究，将有助于进一步降低我国ROP发病率和致盲率
Objective To observe the therapeutic efficacy of widefi eld digita l pediatric retinal imaging system (RetCam II)assisted photocoagulation on ret in opathy of preamturity (ROP). Methods The clinical data of 30 p atie nts (58 eyes) with threshold ROP or prethreshold type I ROP were retrospectively analyzed. The nonperfusion area underwent semiconducting photocoagulation wit h 532 nm under indirect binocular ophthalmoscope. In 30 patients, prethreshold ty pe 1 ROP was found in 36 and threshold ROP was in 19; missed area after cryotherapy in other hospital was observed in 3; Zone 1 ROP was in 8 and z one 2 ROP was in 50. Fiftyfour eyes (93.1％) underwent onetime photocoagulat i on and 4 eyes (6.9%) underwent a second. Ocular fundus was examined by RetCam II before and after operation. The missed area after cryoth erapy was at once supplemented during surgery. The followup duration was 3－11 m onths (average of 5.5 months). Results Fiftyfour eyes which had under gone onetime photocoagulation had good result 1－3 weeks after surgery and the disease was controlled. In 4 eyes which had undergone t he second photoco agulation, the disease alleviated after the operation in 2 and local posterior t ractional retinal detachment occurred in 2. At the end of followup duration, u n favorable retinal structural outcome was observed in 2 eyes (3.4%). Con clusion R etCam IIassisted photocoagulation can avoid missed area during the operation， enhance successful rates of first photocoagulation and reduce unfavorabl e retinal structural outcome rates.
Objective To observe the clinical therapeutic effect of v itrectomy with closed triple incisions on stage 4 or 5 retinopathy of prematurity (ROP). Methods The clinical data of 32 eyes of 26 infants with stage 4 or 5 ROP who un derwent vitrectomy with closed triple incisions from Jan. 2003 to Jan. 2007 were retrospectively analyzed. The 26 infants included 18 males and 8 females, with the gestational age of 27－35 weeks (average 29.4 weeks) and the birth weight of 960－2200 g (average 1434.6 g). The age at the operation was 50-705 days with t he average of 158.3 days. In these 32 eyes, stage 5 ROP was in 13, stage 4 ROP was in 19 (stage 4A in 10 and 4B in 9) in which 11 eyes underwent indirectophthal m oscope photocoagulation because of threshold and type 1 prethreshold ROP and 1 eye underwent cryotherapy again with the disease developing into stage 4 or 5. T he entrance of vitrectomy was closed triple incisions. The lens were saved in 11 eyes and removed in 21 eyes. The followup duration was 2-24 months and the c ondition of retinal reattachment was observed. Results The procedures of operative therapies on 26 affected infants ran smooth. In the 19 eyes at stage 4 ROP, the retina reattached completely in 10 at stage 4A (100%), in which macular traction at optic disc was in 3, remained proliferative membran e in front of the optic disc, in front of the nasal retina and at the peripheral area of the temporal side was found in 4, few vitreous hemorrhage after the ope ration was in 1 which was absorbed 2 weeks later, and cataract after the operati on was in 1; in 9 eyes at stage 4B, retina reattached completely in 6 (66.7%), m acular traction at optic disc was in 1, and retina remained detached in 3 with v itreous hemorrhage after the operation including 2 eyes with anterior chamber he morrhage. In 13 eyes at stage 5, retinal reattached completely in 3 (23.1%) in w hich scars in the peripheral retina, thin retinal vessels and pale optic disc wa s found in 2 and retinal rumple at the temporal side was found in 1; retina reat tached mostly in 1 eye (7.7%) with retinal proliferative membrane and slight re t inal detachment at the nasal side; retina remained detached in 7 eyes. Conclusion Vitrectomy with closed triple incisions for stage 4 ROP may lead the retina l reattachment effectively, but the therapeutic effect is not good on the infant s with stage 5 ROP.
Objective:To evaluate the clinical effects of vitrectomy on total retinal detachment in patients with retinopathy of prematurity (ROP). Methods:The clinical data of 73 eyes of 56 patients with total retinal detachment in ROP (stage 5) who had undergone vitrectomy were retrospectively analyzed. The age o f the patients when underwent the surgery was 384 months old with the average o f (13.02plusmn;14.64) months. The gestation age ranged from 25 to 36 weeks with the average of (29.5plusmn;2.22) weeks; the birth weight ranged from 900 to 2500 g wit h th e average of (1400.19plusmn;300.05) g; the oxygeninhaling time ranged from 2 to 9 0 days with the average of (20.53plusmn;18.91) days. The surgery included open vitr ectom y, closed lens extraction, and vitrectomy. The anatomical outcomes of retinal re attachment were categorized as success: macular reattachment; partial success: macular detachment; and failure: total retinal detachment.Results:After the operation, the anatomical outcome was succeed in 10 eyes (13.69%), partially succeed in 20 eyes (27.39%), and failed in 43 eyes (58.9%). The visual acuity was hand moving in 9 eyes (12.33%), and the grating acuity was better than 0.004 in 6 e yes (8.21%) after the surgery.Conclusions:The procedures of vitrectomy for retinal detachment in ROP is difficult, and the prognosis of the operative therapy is poor. After t he operation, only a few patients get retinal reattachment, and few have certain extent recovery of the visual acuity.
Objectives To observe the characteristics of occurrence a nd progres s of retinopathy of prematurity (ROP) in premature infants and search the reason able ROP screening time and therapeutic methods.〓〖WTHZ〗Methods〓〖WTBZ〗ROP s creening was perf ormed on 829 infants, with the gestational agele;35 weeks and the birth weightle; 2000 g, by indirect ophthalmoscopy combined with scleral pressurizing implement. Thirtytwo infants with prethreshold type I and threshold ROP underwent cryot he rapy. The followup duration after the operation was 316 months, and the crit er ia of the control of the diseases included: alleviation of the plus disease, all eviation of the vascular ridge, formation of the cryospots, absorption of vitr e oretinal hemorrhage, and non bad retinal structure. If the disease was not contr olled, recryotherapy or vitrectomy would be carried out.〓〖WTHZ〗Results〓〖W TBZ〗ROP was fou nd in 86 infants (172 eyes). The difference of oxygen duration time among ROP g roups and nonROP group was significant; the occurrence rate of ROP in the infa n ts with the birth weightle;1000 g, 10011500 g and 15012000 g was 6956%, 16 38% , and 414%, respectively; the occurrence rate of ROP in the infants with the g estat ional agele;30 weeks, 3132 weeks, and 3335 weeks was 37.14%, 10.43%, and 2.91 %, respectively; the occurrence rate of ROP in singleembryo infants group and mul t iple embryo infants group was 7.52% and 20.22%, respectively. Favorable outcom e was observed in 30 out of 32 infants who had undergone cryotherapy; 2 infants d eveloped retinal detachment with plus disease and peripheral retinal hemorrhage. The sccess rate of cryotherapy is high in the infants with the gestational age lt;32 weeks.〓〖WTHZ〗Conclusions〓〖WTBZ〗The ROP incidence rate is higher in the infants with lo ng oxygenbreathing duration, birth weighle;1000 g, and gestational age le; 32 we ek infants, which should be screened carefully. The infants having ROP onset within 32 weeks, with plus disease, and peripheral retinal hemorrhage should be follow ed up closely. The prognosis of cryotherapy for type I prethreshold and thresh old ROP is good and the operation is safe.