未熟児網膜症Ⅰ型全周型発生の推移

Changing trends of circumferential type of retinopathy of prematurity

　1988年までの14年間に出生し，名市大病院新生児集中治療室で管理された極小未熟児を，前後7年間のA群112例，B群125例に分けて比較した。未熟児網膜症（ROP）Ⅰ型で病変が全周に出現する症例（全周型）がA群で5例，B群では19例と，B群で有意に増加していた（p＜0.01）。この全周型は未熟性の点ではⅡ型と似ていたが，瘢痕期2度弱度以下の軽症となった。鼻側からROPの発生した症例はすべて全周型を示し，きわめて未熟な症例の初発部位の多くは，鼻側であると考えられた。近年の全周型の増加は，non—invasive monitoring systemなどによる児の管理の進歩によって，従来はⅡ型のような重症となる症例が移行したものと推察した。

We reviewed 237 premature infants with a birth-weight of 1,500 g or less who were admitted to our neonatal intensive care unit during a 14-year period, 1975-88. There were 112 infants during the first 7 years (group A) and 125 infants during the second 7 years (group B). Incidence of cases with circumferential demarcation line in the peripheral fundus (C-type) was significantly higher in group B than in goup A (p＜0.01). Infants with C-typeretinopathy of prematurity (ROP) showed status of prematurity similar to type Ⅱ or intermediate type of ROP regarding gestational period and birth-weight. C-type ROP turned into grade 2, mild sub-grade, or less during the cicatricial phase. All the eyes in which ROP started in the nasal periphery progessed to C-type ROP. Recent increase in C -type ROP and decrease of type Ⅱ or intermediate type ROP seemed to reflect advances in noninvasive monitoring of premature infants.