Objective To analyze the association of postnatal weight gain proportion of very low birth weight (BW) preterm babies and the onset of severe retinopathy of prematurity,and investigate the optimal cut-off points and predictive ability of postnatal weight gain (WG) proportion for the onset of retinopathy of prematurity (ROP).Methods A retrospective cohort study.257 preterm infants underwent screening whose weight was less than 1500 g were enrolled in this study.Risk factors include BW,gestational age (GA),history of oxygen inhalation,need for blood transfusions,Apgar score in 1 to 10 minutes,embryo number,delivery mode,in vitro fertilization infants,and WG proportion within 6 weeks after birth and other systemic diseases were recorded.Their correlation with severe ROP is analyzed.Clinical outcomes were divided into severe ROP group (patients who suffered from ROP and required treatment) and mild and no ROP group (patients who suffered from ROP but do not require treatment and-patient without ROP).The severe ROP group included 18 patients and mild and no ROP group included 239 patients.Multiple logistic regression and receiver operating characteristic (ROC) curve were used to determine if the WG proportion was independently related to severe ROP development and if it was capable of predicting severe ROP.This study determines the predict value by comparing the area under the ROC curve (AUC) of independent risk factors.Results GA (t=-4.835,P＜0.001),BW(t=-5.192,P＜0.001),history of oxygen inhalation (x2=6.001,P=0.009),proportion of infants who had oxygen inhalation for more than 10 days(x2 =10.019,P=0.002),postnatal WG proportion at 1 week(t =-3.663,P＜ 0.001),postnatal WG proportion at 2 weeks(t=-3.425,P=0.001) had significant difference between two groups.Multiple logistic regression analysis revealed that GA (β =-0.858,P =0.008),BW (β =-0.005,P =0.010),postnatal WG proportion at 2 weeks (β=-8.745,P =0.035) were correlated to severe ROP significantly.And their area under the ROC were 0.836[95％ confidence interval (CI):0.752-0.920],0.826 (95％CI:0.947-0.903),0.744 (95％CI:0.598-0.891) respectively.The optimal cut-off points of GA,BW,and postnatal WG proportion at 2 weeks were 28.41 weeks,1241.96 g,12.80％ respectively.Conclusion Low WG proportion at 2 weeks of very low BW preterm babies is an important and independent risk factor for severe ROP and has certain predictive value of the onset of severe ROP.

Background Current researches of choroidal structure changes primarily focus on macular choroidal thickness in adolescents and children,but there are few studies on peripapillary choroidal thickness in children with enhanced depth imaging (EDI)-OCT.In addition,the reliability of manual measurements to peripapillary choroidal thickness is an important factor for the estimation of EDI-OCT.Objective This study was to determine the repeatability and reproducibility of manual measurements of peripapillary choroidal thickness in children by EDI-OCT.Methods A reliability evaluation of diagnosis test was performed.EDI-OCT technology was used to image the peripapillary choroidal thickness in 49 children aged 7-14 years in Eye Hospital of Wenzhou Medical University from February to March 2015 under the informed consent of their custodians.An annular scanning was carried out surrounding optical disc by the same ophthalmologist with Spectralis OCT,and the peripapillary choroidal thickness was manually measured at global,temporal,superotemporal,superonasal,nasal,inferonasal and inferotemporal zones.The intraclass and interclass repeatability and reducibility of measuring values from intraobserver,inter-observer and intra-session were evaluated with intraclass correlation coefficients (ICC),and BlandAltman agreement analysis was used to assess the consistency of repeated measurements.Results The average age in the subjects was (9.9 ± 1.3) years.No significant difference was found in the mean difference of reduplicative measured peripapillary choroidal thickness at each zone (all at P＞0.05).The ICCs of intra-observer,inter-observer and intra-session were 0.971-0.993,0.827-0.952 and 0.974-0.991,respectively,and the 95％ limit of agreement of global peripapillary choroidal thickness were-12.4-9.7 μm,-15.2-11.6 μm and-16.3-19.1 μm,respectively.Conclusions The repeatability,reproducibility and consistency are favorable in manually measured values of peripapillary choroidal thickness from EDI-OCT image.EDI-OCT appears a good application in the assessment of peripapillary choroidal thickness in children.

Objective:To describe the spectral-domain optical coherence tomography (SD-OCT) features of retinal tuft.Methods:A retrospective clinical study. From May 2019 to April 2020, 22 patients (22 eyes) diagnosed as retinal tuft by clinical fundus examination in Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study. There were 9 eyes in 9 males and 13 eyes in 13 females. All patients underwent ultra-widefield laser scanning fundus photography and SD-OCT examination. SD-OCT was performed with a 55° wide-angle lens to observe the morphology, color, size and location of the lesions.Results:Twenty-six retinal tuft lesions were found in 22 eyes, all of which were solitary, gray, thylakoid and protrusion. SD-OCT images showed that all the lesions of retinal tuft showed a local protuberant appearance with moderate and hyperreflectivity, which was higher than the surrounding retina plane. In 22 lesions (84.62%, 22/26), there were one or more irregular hyporeflective cavities between the retinal neuroepithelial layers, and the other 4 lesions (15.38%,4/26) contained no hyporeflective cavities. In addition, 23 cases (88.46%, 23/26) with hyperreflective condensed cortical vitreous attached to the retina at the top of lesions, 8 cases (30.77%, 8/26) with retinal tear, and 6 cases (23.08%, 6/26) with shallow retinal detachment.Conclusions:In SD-OCT, the retinal tufts show moderate and strong local protrusion, which are higher than the surrounding retinal plane. In most of the lesions, there are multiple or single irregular weak reflex cavities, and there are hyperreflective condensed cortical vitreous attached to the retina at the top of lesions. Local retinal tears or shallow retinal detachment are present in some lesions.