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2형 미숙아망막병증의 발생 후 진행에 관련된 위험인자 분석

Risk Factors that Affects Progression of Type 2 Retinopathy of Prematurity

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초록

목적: 2형 미숙아망막병증 발생 후 진행하여 치료를 필요로 하게 되는 위험인자를 알아보고자 하였다. 대상과 방법: 출생 체중 1,500 g 이하 또는 재태연령 32주 미만으로 출생한 미숙아를 대상으로 선별검사를 시행하였다. 이 중 2형미숙아망막병증에 도달한 경우와 더 진행하여 1형 미숙아망막증 또는 문턱 단계 미숙아망막병증으로 발전하여 치료를 시행한 경우에 대한 위험인자를 분석하였다. 위험인자는 전신 위험인자와 눈 위험인자로 구분하여 분석하였다. 결과: 162명의 324안이 선별검사 대상이 되었으며 41안(12.65%)에서 2형 미숙아망막병증으로 진행하였고, 1형 혹은 문턱 미숙아망막병증으로 진행하여 치료를 시행한 경우는 21안(6.48%)이었다. 2형 미숙아망막병증에서 진행하여 치료를 시행하게 하는 전신 위험인자는 뇌실주위백질연화증이었으며, 눈 위험인자는 2형 미숙아망막병증 진단 당시 비측 망막의 미숙아망막병증 병변의 발생이었다. 결론: 제2형 미숙아망막병증에 도달한 경우 뇌실주위백질연화증과 비측 미숙아망막병증이 존재하면, 치료가 필요한 미숙아망막병증으로 진행할 가능성이 커지므로 보다 주위 깊은 관찰이 필요하다.

Abstract

Purpose: To identify risk factors that affect the development of type 2 retinopathy of prematurity (ROP) and progression to type 1 or threshold ROP requiring treatment. Methods: The medical records of premature infants born with a birth weight ≤1,500 g or a gestational age ≤32 weeks were retrospectively reviewed. Potential risk factors were divided into systemic and ophthalmic factors and analyzed by univariate and multivariate logistic regression analyses. Results: Three hundred and twenty-four eyes met the screening criteria. Among them, 41 eyes (12.65%) progressed to type 2 ROP and 21 eyes (6.48%) received treatment after progression to type 1 or threshold ROP. The systemic risk factor associated with progression from type 2 ROP was periventricular leukomalacia and the ophthalmic factor was the existence of nasal ROP at the time of diagnosis of type 2 ROP. Conclusions: Careful examination was needed when type 2 ROP with periventricular leukomalacia or nasal ROP developed because there was a high probability of progression and treatment.

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