Optomed手持式数码相机在早产儿视网膜病变筛查中的临床应用  

Clinical application of Optomed handheld digital camera in the screening of retinopathy of prematurity

作　　者：叶海昀[1] 王斯颖[1] 李苑[1] 乔彤[1] 

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院,200062

出　　处：《中国斜视与小儿眼科杂志》2017年第3期15-17,6,I0006,共5页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的比较和探讨OPTOMED手持式数码相机(Optomed Smartscope,OS)与RetCam数字视网膜成像系统(RetCamⅢ,RC)在筛查早产儿视网膜病变(ROP)的应用情况。方法研究收集2015~2016年在上海市儿童医院诊治的807例(1614眼)平均胎龄31.72W(24~36W)、平均出生体重1691.72g(620~2490g)的早产儿进行ROP筛查。所有新生儿均分别行OPTOMED手持相机(OS组)和RetCam(RC组)检查,采用双目间接检眼镜检测为标准对照。通过评估ROP阳性筛查率及眼底观察范围,比较两种方法的筛查结果。结果 807例早产儿ROP筛查(双目间接眼底镜检查)阳性例数为32例(49眼,3.04%),确诊ROP并于定期复查(2~8周)后病变消退者22例(33眼,31.25%)。ROP筛查阳性患儿中Ⅰ区3期合并plus病变5例(10眼),Ⅱ区3期9例(11眼),Ⅲ区18例(28眼)。RC组ROP筛查结果(阳性32例,49眼)与双目间接眼底镜检查一致,灵敏度为100%;OS组筛查ROP阳性30例(47眼),灵敏度为93.75%(约登指数为0.94),假阴性2例(2眼),均为Ⅲ区1期患儿,病变在随访过程中消退。结论使用OPTOMED手持式数码相机进行新生儿ROP眼底检查是安全有效的筛查手段,为临床早产儿ROP筛查工作提供更多选择。Objective To compare and discuss the application of OPTOMED handheld digital camera （Optomed Smartscope, OS） and RetCam digital retina imaging system （RetCam Ⅲ, RC） in screening retinopathy of prematurity （ROP）. Methods 807 infants （1614 eyes） with 31.72W （24～36W） and mean birth weight of 1691.72g （620～2490g） were enrolled in the ROP screening in Shanghai Children＇s Hospital during 2015～2016 years. All newborns were performed OPTOMED handheld camera （OS group） and RetCam （RC group）, using binocular indirect ophthalmoscope detection as the standard control. The screening results of the two methods were compared by assessing the positive ROP screening rate and the range of fundus observation.Results In 807 cases of premature infants, 32 cases （49 eyes, 3.04%） were positive for ROP screening, and the lesions in 22 cases （33 eyes, 31.25%） were subsided during regularly follow-up （2～8 weeks）. Among the patients with positive ROP screening, 5 cases （10 eyes） were positive in Zone Ⅰ Phase 3 complicated with Plus disease, 9 cases （11 eyes） in Zone Ⅱ Phase 3, 18 cases （28 eyes） in Zone Ⅲ. Results in RC group （ROP positive in 32 cases, 49 eyes） was coincident with binocular indirect ophthalmoscope results, the sensitivity was 100%. OS group results were： ROP positive in 30 cases （47 eyes）, the sensitivity was 93.75% （Youden index was 0.94）, false negative in 2 cases （2 eyes） which were Zone Ⅲ Phase 1 and thelesion subsided during follow-up.Conclusion Using OPTOMED handheld digital camerafor neonatal ROP fundus screening is a safe and effective examination method, which provides more choice for clinical preterm infants ROP screening.

关 键 词：手持式数码相机 ROP 筛查 

分 类 号：R774.1[医药卫生—眼科]