超および極小未熟児の未熟児網膜症発症率と治療成績

Incidence and therapeutic outcome of retinopathy of prematurity in extremely-and very-low-birthweight infants

　1981年から1993年に生まれた出生体重1,500g未満の極小未熟児399例と1,000g未満の超未熟児682例の合計1,081例について，出生体重別，在胎週数別に，未熟児網膜症の発症率，治療率，瘢痕期2度以上の瘢痕例の発症率を求めた。未熟児網膜症の発症は590例，治療数は80例，綴痕期2度以上の瘢痕例は20例であった。発症率は出生体重および在胎週数が小さいほど大きくなっており，特に出生体重1,000g，在胎週数29週を境にしてその発症率が急激に増加していた。未熟児網膜症の管理は，出生体重1,000g未満，在胎週数29週未満の症例では特に注意深い経過観察が必要であると考えられた。

We reviewed a series of 1081 premature infants during the foregoing 13-year period. The series comprised 399 very-low-birthweight infants of less than 1500g and 682 extremely-low-birthweight ones of less than 1000g. The cases were divided into subgroups according to the birthweight and gestational age. They were evaluated as to the incidence of retinopathy of prematurity (ROP), therapeutic interventions, and the final clinical outcome. ROP was present in 54.6%. Surgery was performed on 80 cases. Dragged disc or retrolental fibroplasia resulted in 20 cases. ROP was more frequent in infants with smaller birthweight and shorter gestational age, particularly in those with birthweight of less than 1000g and gestational age of less than 29 weeks. Infants belonging to this subgroup would therefore need close attention regarding the state of retinopathy.