1.Guidelines for the application of artificial intelligence in optical coherence tomography angiography image analysis and ocular disease diagnosis(2024)
Expert Workgroup of Guidelines for Application of Artificial Intelligence in OCTA Image Analysis and Ocular Disease Diagnosis ; Ophthalmic Imaging and Intelligent Medicine Branch of Chi-nese Medicine Education Association ; Ophthalmology Committee of International Association of Translational Medicine ; Yi SHAO ; Xinjian CHEN ; Weihua YANG
Recent Advances in Ophthalmology 2024;44(5):337-345
Optical coherence tomography angiography(OCTA)is a non-invasive imaging technique that provides three-dimensional,informative vascular images.Numerous studies have shown that OCTA technology has unique advantages in biomarker quantification,diagnosis and monitoring,and has therefore been rapidly applied in experiments and clinical stud-ies.Image analysis tools can quickly and accurately quantify vascular and pathological features,greatly improving the value of OCTA imaging.In recent years,artificial intelligence(AI)has become the most powerful image analysis method,espe-cially deep learning-based image analysis,which can provide accurate measurements in various situations,including differ-ent diseases and eye regions.The Ophthalmic Imaging and Intelligent Medicine Branch of Chinese Medicine Education Asso-ciation and the Ophthalmology Committee of International Association of Translational Medicine designated experts to sum-marize the application of AI in OCTA image analysis and disease diagnosis at home and abroad,including accurate detection of choroidal neovascularization and other lesions,accurate quantification of retinal perfusion,and reliable disease diagno-sis.They also analyzed the current challenges and development directions.After multiple rounds of discussion and revi-sions,they drafted the guidelines for the application of AI in OCTA image analysis and ocular disease diagnosis,aiming to provide new insights and references for clinical practice.
2.Effects of dimethyl itaconate on secretion of pro-inflammatory factors in den-dritic cells and on T helper 17 cells in mice with experimental autoimmune uveitis
Jiali WANG ; Chao YANG ; Sisi CHEN ; Kailang ZHANG ; Ruihua WEI ; Hong NIAN
Recent Advances in Ophthalmology 2024;44(5):346-349
Objective To investigate the effects of dimethyl itaconate(DMI)on the secretion of pro-inflammatory factors in dendritic cells(DCs)and on the interphotoreceptor retinoid-binding protein(IRBP)1-20-specific T helper 17(Th17)cells in mice with experimental autoimmune uveitis(EAU).Methods Bilateral femur and tibia of C57BL/6J mice were isolated to obtain bone marrow cells,and these bone marrow cells were directionally induced with granulocyte macrophage-colony-stimulating factor(GM-CSF)and interleukin(IL)-4 to differentiate DCs.After 6 days,DCs were ran-domly divided into the DMI group and the phosphate-buffered saline(PBS)group.Cells in the DMI group were pretreated with 250 μmol·L-1 DMI,and cells in the PBS group were pretreated with the same volume of PBS for 3 hours.After-wards,100 μg·L-1 lipopolysaccharide was added in the every group to stimulate cells for 24 hours.The relative mRNA ex-pression levels of IL-6,IL-1 β,and IL-23 in DCs were measured by quantitative real-time polymerase chain reaction(qRT-PCR).The EAU model was constructed by actively immunizing mice with IRBP1-20,Freund's incomplete adjuvant,and my-cobacterium tuberculosis H37RA.Thirteen days after immunization,T cells in the spleen and lymph node isolated from EAU mice were cocultured with DMI-treatedor PBS-treated DCs in the medium containing IRBP1-20.They polarized toward Th17 cells.The percentage of Th17 cells in the cocultured cells was detected by flow cytometry.The IL-17 level in the coculture supernatant was detected by enzyme-linked immunosorbent assay(ELISA).qRT-PCR was performed to detect the relative mRNA expression levels of retinoid-related orphan receptor gamma t(RORγt),IL-17,IL-23R,and GM-CSF in the cocultured cells.Results qRT-PCR analysis revealed that the relative mRNA expression levels of IL-6,IL-1β,and IL-23 in the DMI group were significantly lower thanthose in the PBS group(all P<0.05).Flow cytometry analysis showed that the proportion of Th17 cells in the cocultured cells in the DMI group was significantly lower than that in the PBS group(P<0.05).ELISA analysis exhibited that the IL-17 level in the coculture supernatant in the DMI group was significantly lower than that in the PBS group(P<0.05).The relative mRNA expression levels of IL-17,ROR-γt,IL-23R and GM-CSF in cocultured cells in the DMI group significantly decreased compared with the PBS group(all P<0.05).Conclusion DMI can reduce the expression of IL-6,IL-1β and IL-23 in DCs,thus negatively modulating the responses of IRBP1-20-specific Th17 cells.
3.Corneal wound healing mechanism after infrared laser irradiation
Yixue YIN ; Luguang JIAO ; Jiarui WANG ; Congling ZHOU ; Zaifu YANG
Recent Advances in Ophthalmology 2024;44(5):350-354
Objective To explore the corneal wound healing mechanism after 3.74 μm infrared laser irradiation.Methods Twenty-seven C57BL/6J mice(six to eight weeks old)were randomly divided into a normal group(3 mice)and an experimental group(24 mice).Mice in the normal group were not subjected to any treatment.The corneas of mice in the experimental group were damaged by infrared laser at a wavelength of 3.74 μm.The spot diameter was 2 mm,the exposure duration 0.8 s,and the radiant exposure 23.2 J·cm-2.Pathological sectioning of corneas was performed at 3 h,6 h,12 h,1 d,3 d,7 d,14 d,and 21 d after laser irradiation in the experimental group,with 3 mice at each time point.It was the same for mice in the normal group.Immunohistochemical staining was conducted to examine neutrophil elastase,CD68,CD163 and thrombomodulin-positive cells and identify neovascularization.Results Neutrophil elastase,CD68,CD163,and thrombomodulin-positive cells were not detected in the corneal stroma of mice in the normal group.Neutrophil elastase-positive cells were detected in the damaged corneal periphery of mice in the experimental group at 3 h,migrated to the damaged area at 12 h,peaked at 1 d,and then decreased gradually with time,but still existed slightly at 21 d after laser irradiation.CD68-positive cells were detected in the damaged corneal periphery of mice in the experimental group at 12 h and in the damaged area at 1 d through 21 d after laser irradiation.CD163-positive cells were found in the damaged corneal periphery of mice in the experimental group at 7 d and in the damaged area at 14 d and 21 d after laser irradiation.Throm-bomodulin-positive cells were found in the damaged area of the corneal stroma at 14 d and 21 d after laser irradiation.Con-clusion During the wound healing process after 3.74 μm infrared laser-induced full-thickness corneal injury in mice,a large number of inflammatory cells migrate from the damaged corneal periphery or limbus to the damaged area.Neutrophils and M1 macrophages infiltrate in the early stage,while M2 macrophages are involved in the later stage,accompanied by neovascularization.
4.Effect of phillyrin on high glucose-induced injury of human retinal vascular endothelial cells by regulating complement C1q/tumor necrosis factor-related protein-3 expression and its mechanism
Shasha HAN ; Dan YIN ; Yuefeng LI ; Qin YE
Recent Advances in Ophthalmology 2024;44(5):354-359
Objective To compare the effects of different doses of phillyrin(PHN)on the injury of human retinal vascular endothelial cells(RVECs)induced by high glucose(HG)and analyze its regulatory effect on the expression of complement C1q/tumor necrosis factor-related protein-3(CTRP3)and its possible mechanism.Methods RVECs were cultured with HG to establish cell injury models(HG group).RVECs in the HG+PHN-L group,HG+PHN-M group,and HG+PHN-H group were treated with 1 μmol·L-1,10 μmol·L-1,and 100 μmol·L-1 PHN,respectively,followed by HG induction.RVECs in the HG+pcDNA group and HG+pcDNA-CTRP3 group were transfected with pcDNA and pcDNA-CTRP3,respectively,followed by HG induction.RVECs in the HG+PHN-H+sh-NC group and HG+PHN-H+sh-CTRP3 group were transfected with sh-NC and sh-CTRP3,respectively,then induced by HG and treated with 100 μmol·L-1 PHN.The levels of malondialdehyde(MDA),superoxide dismutase(SOD),and glutathione peroxidase(GSH-Px)were meas-ured.Cell apoptosis was detected by flow cytometry.The expression levels of B-cell lymphoma-2(Bcl-2),Bcl-2-associated X(Bax)and CTRP3 protein were determined by quantitative real-time polymerase chain reaction(qRT-PCR)and Western blot,respectively.Results Compared with the Con group,the cell apoptosis rate and the levels of MDA and Bax protein in the HG group increased,while the levels of SOD,GSH-Px,Bcl-2 protein,CTRP3 mRNA and protein decreased(all P<0.05).Compared with the HG group,the cell apoptosis rate and the levels of MDA and Bax protein in the HG+PHN-L,HG+PHN-M,and HG+PHN-H groups decreased(HG+PHN-H group<HG+PHN-M group<HG+PHN-L group),while the levels of SOD,GSH-Px,Bcl-2 protein,CTRP3 mRNA and protein increased(HG+PHN-H group>HG+PHN-M group>HG+PHN-L group)(all P<0.05).Compared with the HG+pcDNA group,the cell apoptosis rate and the levels of MDA and Bax protein in the HG+pcDNA-CTRP3 group decreased,while the levels of SOD,GSH-Px,CTRP3 protein,and Bcl-2 protein increased(all P<0.05).Compared with the HG+PHN-H+sh-NC group,the HG+PHN-H+sh-CTRP3 group showed an increase in the cell apoptosis rate and the levels of MDA and Bax protein and a decrease in the levels of SOD,GSH-Px,CTRP3 protein,and Bcl-2 protein(all P<0.05).Conclusion PHN can alleviate HG-induced damage to RVECs,which may be related to the upregulation of the CTRP3 expression.
5.Effect of asiaticoside on the repair of human corneal epithelial cell injury in-duced by high glucose
Recent Advances in Ophthalmology 2024;44(5):360-364
Objective To explore the effect and mechanism of asiaticoside(AS)on the repair of high glucose(HG)induced damage to human corneal epithelial cells(HCECs).Methods HCECs were cultured in vitro.The CCK-8 assay was used to detect the effects of different concentrations of glucose and AS on the proliferation activity of HCECs,and the optimal HG concentration(150 mmol·L-1)and AS concentration(20 μmol·L-1)were selected for subsequent experi-ments.HCECs were divided into the blank control group(NC group)(only added with culture medium DMEM),HG group(added with 150 mmol·L-1 glucose),AS group(added with 20 μmol·L-1 AS),and HG+AS group(added with 150 mmol·L-1 glucose and 20 μmol·L-1 AS).The proliferation activity of cells in each group at 24,48,and 72 hours was de-tected by the CCK-8 assay,respectively.The migration ability of cells in each group at 24 hours was detected by the cell scratch assay.TUNEL staining was used to detect the apoptosis rate of cells in each group;RT-PCR was used to detect the mRNA expression of Wnt1,β-catenin,and CyclinD1 in each group of cells;and Western blot was used to detect the protein expression of Wnt1,β-catenin,and CyclinD1 in each group of cells.Results Compared with the NC group,the prolifer-ation activity of cells in the HG group significantly decreased at 24,48,and 72 hours(all P<0.001).Compared with the HG group,the proliferation activity of cells in the HG+AS group significantly increased at 24,48,and 72 hours(all P<0.001).Compared with the NC group,the apoptosis rate of cells in the HG group increased markedly(P<0.001).Com-pared with the HG group,the apoptosis rate of cells in the HG+AS group decreased markedly(P<0.01).Compared with the NC group,the migration ability of cells in the HG group was significantly inhibited(P<0.000 1).Compared with the HG group,the migration ability of cells in the HG+AS group was significantly enhanced(P<0.000 1).Compared with the NC group,the mRNA expression levels of Wnt1,β-catenin,and CyclinD1 in the HG group were significantly reduced(all P<0.05).Compared with the HG group,the mRNA expression levels of Wnt1,β-catenin,and CyclinD1 in the HG+AS group increased notably(all P<0.001).Compared with the NC group,the protein expression levels of Wnt1,β-catenin,and CyclinD1 in the HG group decreased notably(all P<0.01).Compared with the HG group,the protein expression lev-els of Wnt1,β-catenin,and CyclinD1 in the HG+AS group increased remarkably(all P<0.01).Conclusion AS can alleviate HCEC damage caused by HG,promote cell proliferation and migration,and inhibit cell apoptosis.This effect may be achieved by activating the Wnt/β-catenin signaling pathway.
6.Ocular biometric parameters among primary and secondary school students of Naxi,Bai and Han ethnicity in Yunnan Province
Qiang ZHANG ; Litao CHANG ; Peiqian LI ; Jie XIAO ; Dafeng HUANG ; Xueni XIE ; Jin-Jiao ZHANG ; Zixue MA ; Qianqian LI ; Xiao LUO ; Maosen CHEN ; Ying HUANG
Recent Advances in Ophthalmology 2024;44(5):365-369
Objective To assess ocular biometric parameters among primary and secondary school students from Naxi,Bai and Han ethnic groups in Yunnan Province.Methods The school-based study was conducted in October 2020.A total of 724 second-,third-and seventh-graders were selected from Dali and Lijiang,where Bai and Naxi ethnic groups inhabit,using a stratified cluster sampling method to receive questionnaire surveys and eye examinations.Non-cycloplegic spherical equivalent(SE),axial length(AL),anterior chamber depth(ACD),corneal radius of curvature(CR),central corneal thickness(CCT),white-to-white(WTW)distance,and the AL/CR ratio were measured.Covariance analysis was used to examine the differences in SE and ocular biometric parameters in terms of ethnicity,sex and grade,while Pearson correlation was used to test the associations among the said indicators.Results There were no significant differences in daily outdoor time,screen time and sleep time among the three ethnic groups regardless of grades(all P>0.05).The mean CCT of Naxi students was lower than that of Han and Bai students[grade 2 and grade 3:(542.48±39.76)μm vs.(553.81±31.83)μm and(559.27±32.79)μm;grade7:(538.86±34.91)μm vs.(547.41±33.55)μm and(548.26± 32.98)μm,all P<0.05],while no significant differences were found in the other ocular biometric parameters among the three ethnic groups(all P>0.05).Among the seventh-graders,the SE,AL and AL/CR ratio of Naxi students were signifi-cantly different from those of Han and Bai students(all P<0.05).The AL,CR,ACD,CCT,WTW distance,and mean SE were lower in girls than in boys(all P<0.05).Compared with grade 2 and grade 3,students of grade 7 had longer AL,deeper ACD and thinner CCT(all P<0.05),while no significant differences were found in CR and WTW distance(all P>0.05).Correlation analysis showed that the AL/CR ratio was highly correlated with SE(r=-0.78,P<0.05).Conclu-sion Multiethnic primary and secondary school students may face similar environmental risks.Yet,disparities in ocular biometric parameters caused by ethnicity,sex and age should be noted.
7.Refractive prediction error in vitrectomy combined with phacoemulsification and intraocular lens implantation for patients with macular disease and cata-ract
Jiayi KONG ; Zifeng ZHANG ; Manhong LI ; Chaowei TIAN ; Yusheng WANG
Recent Advances in Ophthalmology 2024;44(5):370-375
Objective To analyze the refractive prediction error(PE)in combined vitrectomy,phacoemulsification,and intraocular lens(IOL)implantation for patients with macular disease and cataract.Methods This study encom-passed 96 patients(96 eyes)diagnosed with macular disease and cataract,who underwent combined vitrectomy,phacoe-mulsification and IOL implantation at the Department of Ophthalmology in Xijing Hospital,Air Force Military Medical Uni-versity from May 2014 to November 2022.The best corrected visual acuity(BCVA)and actual spherical equivalent(SE)were studied,PE and absolute refractive error(ARE)were calculated,and the correlations between PE and axial length(AL),anterior chamber depth(ACD),lens thickness(LT),flat keratometry(Kf),steep keratometry(Ks),mean kera-tometry(Km),corneal astigmatism degree(cylinder,Cyl),intraocular pressure(IOP),BCVA,corneal astigmatism axis,the classification of macular diseases,and the type of intraoperative vitreous fillers were analyzed.Results In the early postoperative period(within 3 days after surgery),no statistically significant disparity in BCVA was observed compared to preoperative data among the 96 patients studied(P>0.05).The ARE was determined to be(1.47±2.54)D,indicating a substantial deviation between the actual SE and preoperative predictive refraction of the 96 patients(P<0.05).Among them,61 patients had a myopic shift,35 patients had a hyperopic shift,and the values of PE were(-1.81±3.07)D and(0.87±0.96)D,respectively.At the 1-month mark after surgery,there was no statistically significant difference in BCVA compared to the preoperative data of 12 follow-up patients(P>0.05).Similarly,no statistically significant differences were found between every two of the three data,namely the actual SE one month after surgery,the preoperative predictive refraction,and the actual SE in the early postoperative period of the 12 follow-up patients(all P>0.05).Also,no disparity was observed in BCVA at the last follow-up(P>0.05)among the 6 patients who were followed up for over 1 year(long-term postoperative follow-up).The correlation analysis revealed that,in the early postoperative period,the PE of patients with myopic shift was negatively correlated with both preoperative AL and Cyl measurements(both P<0.05).The early postoperative PE of patients with myopic shift was associated with the diagnostic classification of macular diseases(P<0.05),and the degree of myopic shift was observed to be significantly greater in patients with pathological myopia macular holes compared to those with other macular diseases(P<0.05).Additionally,the early postoperative PE of patients with myopic shift was uncorrelated with preoperative ACD,TL,Kf,Ks,Km,IOP,BCVA,the type of intraoperative vitreous fillers and the corneal astigmatism axis(all P>0.05).In contrast,for patients exhibiting hyperopic shift,the PE observed in the early postoperative period exhibited a positive correlation with preoperative Cyl(P<0.05).PE was also correlated with the type of intraoperative vitreous fillers(P<0.05),and the degree of hyperopic shift was notably enhanced when the intraoperative vitreous cavity was filled with silicone oil(P<0.05).The PE of patients with hyperopic shift observed in the early postoperative period exhibited no correlation with preoperative AL,ACD,TL,Kf,Ks,Km,IOP,BCVA,the diagnos-tic classification of macular diseases or the astigmatism axis(all P>0.05).Conclusion Refractive prediction error may occur in patients with macular disease and cataract in the initial postoperative period after the vitrectomy combined with phacoemulsification and IOL implantation,predominantly caused by myopic shift.However,over time,there is a signifi-cant reduction in the magnitude of this refractive error.The direction and extent of diopter drift appear to be influenced by preoperative AL,Cyl,the specific diagnosis of macular disease,and the type of vitreous cavity filler utilized in the surgical procedure.
8.A comparative study of choroidal parameters in contralateral eyes of patients with pachychoroid neovasculopathy and central serous chorioretinopathy
Bei XIAO ; Yanping SONG ; Ming YAN ; Ya YE ; Zhen HUANG
Recent Advances in Ophthalmology 2024;44(5):376-381
Objective To compare choroidal parameters and morphological changes in asymptomatic contralateral eyes of patients with pachychoroid neovasculopathy(PNV)and central serous chorioretinopathy(CSC)using ultra-wide-field swept-source optical coherence tomography angiography(UWF SS-OCTA).Methods A prospective,cross-section-al,observational study was conducted,including 23 asymptomatic contralateral eyes of 23 CSC patients and 19 asympto-matic contralateral eyes of 19 PNV patients treated in our Ophthalmology Department from April 2023 to September 2023,as well as 22 eyes of 22 age-and sex-matched healthy individuals.These eyes were divided into the CSC contralateral eye group,PNV contralateral eye group,and healthy eye group,respectively.There was no statistically significant difference in age,male ratio,and best corrected visual acuity among the three groups(all P>0.05).All subjects underwent UWF SS-OCTA imaging examination and comparison,and their choroidal thickness(CT),vascular density(VD)in the major vas-cular layer of the choroid(ratio of blood flow pixel area to total area of the target area),and choroidal vascular index(CVI)(ratio of choroidal vascular lumen volume to total volume of choroidal vessels and stromata)in 9 zones(superior temporal,superior,superior nasal,temporal,foveal,nasal,inferior temporal,inferior,and inferior nasal)were measured and recorded,respectively.The macular subfoveal retinal thickness,subfoveal choroidal thickness(SFCT),and asymmet-ric dilation and anastomosis of the vortex veins were examined and compared in each group of patients.Results There was a statistically significant difference in macular SFCT among the three groups(all P<0.01).There was a statistically significant difference in the proportion of asymmetric dilation or anastomosis of the vortex veins among the three groups(all P<0.001).The CVI in the superior nasal and nasal zones in the CSC contralateral eye group were higher than those in the PNV contralateral eye group(both P<0.05).The CVI and average CVI in the superior nasal,temporal,foveal,inferi-or,and inferior nasal zones in the CSC contralateral eye group were higher than those in the healthy eye group(all P<0.05).The CVI in the temporal,foveal,and inferior zones in the PNV contralateral eye group were higher than those in the healthy eye group(all P<0.05).The VD in the major vascular layer of the choroid in the superior temporal,superior,su-perior nasal,foveal,and inferior temporal zones in the CSC contralateral eye group were lower than those in the healthy eye group(all P<0.05).The VD in the major vascular layer of the choroid in the PNV contralateral eye group were lower than that in the healthy eye group in all zones(all P<0.001).The CT in the superior temporal and superior nasal zones in the CSC contralateral eye group were higher than those in the PNV contralateral eye group(both P<0.05).The CT in the superior temporal,superior,superior nasal,temporal,foveal,inferior,and inferior nasal zones in the CSC contralateral eye group were higher than those in the healthy eye group(all P<0.05).The CT in the superior,temporal,foveal,and in-ferior zones in the PNV contralateral eye group were higher than those in the healthy eye group(all P<0.05).Conclu-sion This study provides validation from the perspective of the fellow eye that CSC and PNV may not be different stages of the same disease.CSC and PNV are not unilateral diseases,but bilateral choroida diseases that manifest in one eye.
9.Epidemiological burden of glaucoma in China based on Global Burden of Dis-ease database
Tianyu GAO ; Xutao GUAN ; Ruibao LIU ; Xirui YANG
Recent Advances in Ophthalmology 2024;44(5):382-386,390
Objective To analyze the epidemiological burden of glaucoma in China based on data from the Global Burden of Disease 2019(GBD 2019)database to provide a theoretical basis for the prevention and control of glaucoma in China.Methods Analysis of the glaucoma epidemic trend and age,period,and gender trends in China from 1990 to 2019 and the correlation between glaucoma and the Socio-Demographic Index(SDI)were conducted according to relevant data on the number of patients,prevalence,disability-adjusted life years(DALYs)and DALY rates downloaded from the GBD 2019 database.Results In 2019,China was ranked globally first for the number of people with glaucoma and second for DALYs due to glaucoma.In 2019,China's glaucoma prevalence was among the highest globally,with the number of pa-tients being 1.92 times that of 1990.Both the prevalence and the DALY rate demonstrated a persistent upward trajectory.The demographic distribution of patients with glaucoma in China revealed a curve which peaked among middle-aged individ-uals,with higher prevalence observed in males than females.An inverse correlation was identified between SDI and the age-standardized prevalence and DALY rates,which exhibited a negative average annual percentage change,indicative of a pro-gressive decline with rising SDI.Conclusion From 1990 to 2019,China experienced a significant increase in the burden of glaucoma,ranking among the highest globally,with a positive correlation observed between the disease burden and the level of social development.
10.The predictive value of pulse oxygen perfusion index and blood lactic acid concentration for early retinopathy of prematurity
Bing ZHANG ; Xiaoxiao ZHAO ; Yujuan HE ; Weixing ZHANG ; Ximin FENG
Recent Advances in Ophthalmology 2024;44(5):387-390
Objective To investigate the value of pulse oxygen perfusion index(PI)and blood lactic acid(BLA)concentration in early prediction of retinopathy of prematurity(ROP).Methods A retrospective case-control study was conducted on 128 preterm infants who met the inclusion criteria and were admitted to the neonatal intensive care unit of our hospital from September 2018 to December 2022.Among them,46 patients with ROP were in the ROP group,and 82 pa-tients without ROP were in the non-ROP group.Basic data of these preterm infants were recorded after admission.PI val-ues were continuously monitored with the Masimo Radical-7(USA)SpO2 blood oxygen saturation detector,and BLA con-centrations were detected with the ABL90FLEX blood gas analyzer.The receiver operating characteristic(ROC)curve and area under curve(AUC)were used to evaluate the value of PI and BLA concentration in early prediction of ROP.Results There were no significant differences in gestational age,birth weight,sex,and delivery mode between the two groups(all P>0.05).The PI values after birth were significantly different between the two groups(Fgroup=15.393,Pgroup<0.001).The PI values of preterm infants in the ROP group decreased significantly at 1 h,12 h and 24 h after birth and slightly at 48 h to 96 h after birth compared with the non-ROP group.The PI values of preterm infants in the two groups sta-bilized at 96 h after birth.The PI values of preterm infants in the ROP group were lower than those in the non-ROP group at all time points within 96 h after birth(all P<0.05).The PI values showed interaction effects between the two groups at different time points(Finteraction=5.061,Pinteraction<0.001).There was a significant difference in BLA concentration between the two groups after birth(Fgroup=91.158,Pgroup<0.001).In the ROP group,the BLA concentration increased significantly at 1 h after birth and slightly at 12 h and 24 h after birth compared with the non-ROP group.The BLA concentration in the ROP group was higher than that in the non-ROP group at all time points after birth(all P<0.05).The BLA concentration showed no interaction effects between the two groups at different time points(Finteraction=0.567,Pinteraction>0.05).The AUC of PI values at 1 h,12 h and 24 h after birth and BLA concentration at 1 h after birth for predicting ROP was 0.77,0.82,0.83,and 0.82,respectively.The AUC of combined PI values at 1 h,12 h and 24 h after birth and BLA concentration at 1 h after birth for predicting ROP was 0.94,higher than the predictive value of a single indicator.Conclusion PI and BLA concentration have good clinical value for early prediction of ROP.

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