未熟児網膜症の初回検査時期の意義

Optimum timing of first examination for retinopathy of prematurity

　未熟児網膜症の初回検査の時期を検討するため，過去7年間に診察した出生体重1,500g未満の未熟児233名のうち，網膜症のある129名を検索した。生後約3週の初回検査で，49名（38％）に網膜症があった。網膜症のある群は，ない群よりも，出生時の在胎週数と出生体重が有意に大きく，必要治療率が低かった。治療時期には両群間に差がなく，修正在胎週の34から35週であった。初回検査から治療までの期間は，網膜症のある群は11日で，ない群の35日よりも有意に短かった。出生在胎週数が大きい児は，生後3週後に網膜症がすでに発症していることが多いので，生後2週に初回検査を行うことが望ましいと結論される。

In order to determine the optimum timing of first examination for retinopathy of prematurity (ROP), we reviewed 129 infants with ROP out of a series of 233 premature infants with birthweight of 1,500g or less seen during the foregoing 7 years. ROP was detected in 49 infants (38%) at the first examination 3 weeks after birth. These 49 infants had a longer gestational age at birth and greater birthweight than the other 80 infants who did not manifest ROP at the first examination. The interval between the first examination and the start of treatment was 11 days in the former group and 35 days in the latter. The timing of start of treatment was the same at 34 to 35 weeks of gestational age in both groups. These findings suggest that premature infants with longer gestational age at birth should be first examined 2 weeks after birth.