The characteristics of premature infants with transient corneal haze

BackgroundThe etiology of transient corneal haze in premature infants is not known and how it relates to clinical outcomes in premature infants is not clear.ObjectivesTo study associated factors of transient corneal haze in premature infants.MethodsWe performed a retrospective study of 261 premature infants from retinopathy of prematurity (ROP) screening in the neonatal intensive care unit at a tertiary referral hospital. Characteristics of premature infants with and without corneal haze were analyzed by correlation tests, Chi-square tests, and logistic regressions were used for statistical analyses. Associations between corneal haze and birth weight (BW), gestational age at birth (GA), central corneal thickness, intraocular pressure, and other systemic and ophthalmic data were evaluated.ResultsThe incidence of corneal haze was 13.4%. Lower BW, lower GA, packed red blood cells (RBC) transfusion, more days on oxygen, older maternal age, bronchopulmonary disease, and stage 3 ROP are associated with corneal haze. The severity of corneal haze decreased with infants’ postmenstrual age. Multivariate logistic regression analyses revealed that BW and maternal age are the most important predictors of corneal haze.ConclusionLow BW and older maternal age are the most important predictors of corneal haze in premature infants. Premature infants with corneal haze could carry more systemic and ocular morbidities. Hence they may require more clinical attention. Corneal haze is unlikely to hinder the treatment of ROP. However, it is possible that corneal haze could hinder the examination of ROP in some infants. If corneal haze does interfere with ROP screening, a closer, more conservative follow-up schedule with a senior ophthalmologist experienced in managing ROP is recommended.背景：早产儿一过性角膜混浊（transient corneal haze）的病因尚未明确，其与早产儿临床结局的关联亦尚未明晰。 研究目的：旨在探究早产儿一过性角膜混浊的相关影响因素。 方法：本研究为回顾性研究，纳入某三级转诊医院新生儿重症监护病房内接受早产儿视网膜病变（retinopathy of prematurity）筛查的261例早产儿。通过相关性检验、卡方检验分析伴与不伴角膜混浊的早产儿的临床特征，并采用logistic回归进行统计学分析。评估角膜混浊与出生体重（birth weight）、出生胎龄（gestational age at birth）、中央角膜厚度、眼压及其他全身与眼科相关数据之间的关联。 结果：早产儿一过性角膜混浊的发生率为13.4%。低出生体重、低出生胎龄、浓缩红细胞（packed red blood cells）输注、氧疗时长更长、产妇年龄更高、支气管肺疾病以及3期早产儿视网膜病变均与角膜混浊存在关联。角膜混浊的严重程度随患儿校正胎龄的增加而降低。多因素logistic回归分析显示，出生体重与产妇年龄是角膜混浊最为重要的预测因子。 结论：低出生体重与产妇年龄升高是早产儿一过性角膜混浊最为重要的预测因子。伴角膜混浊的早产儿往往合并更多全身与眼部并发症。因此，此类患儿需获得更多的临床关注。一过性角膜混浊一般不会阻碍早产儿视网膜病变的治疗，但在部分患儿中可能会干扰其检查。若角膜混浊确实影响了早产儿视网膜病变筛查，建议由擅长该病诊疗的资深眼科医师制定更为严密且保守的随访方案。