关键词: 早产儿视网膜病变, 教学

Abstract:  Objective To compare the advantages and effects of wide area digital retinography and binocular indirect ophthalmoscope in teaching retinopathy of prematurity (ROP). Design Prospective comparative teaching study. Participants 42 interns in the ophthalmology department of Beijing Children's Hospital from 2019 to 2023. Methods 42 subjects were divided into two groups according to a random comparison table. Group A included 21 subjects. In the first month, binocular indirect ophthalmoscope (BIO) was used for fundus teaching and training of premature infants and then wide field digital retinography (WFDR) was used for teaching and training for the second month. In group B, 21 subjects were treated with WFDR for the first month, followed by BIO for the second month. At the end of the first month, the BIO teaching of group A and WFDR teaching of group B were evaluated. At the end of second months, the WFDR teaching of group A and BIO teaching of group B were evaluated. The assessment contents include disease diagnosis and monocular fundus examination time. At the end of the second month, a questionnaire survey was conducted. Main Outcome Measures Mastering time, monocular examination time, disease diagnosis score, ten characteristics of questionnaire survey. Results The ROP zone scores of BIO and WFDR were 78.80±9.67 and 79.21±8.90 (t=0.352, P=0.726). Plus lesion score was 79.53±9.09 for BIO and 77.85±7.81 for WFDR (t=0.901, P=0.370). The stage score of BIO was 82.61±7.67, higher than that of WFDR 78.09±6.34 (t=6.165, P<0.001). The hour range score of BIO was 80.85±7.17, which was lower than that of WFDR (83.33±6.11) (t=-10.664, P<0.001). The monocular examination time was (7.47±1.64) minutes for BIO, which was higher than that for WFDR (3.30±0.56) minutes (t=15.582, P<0.001). The mastery time of BIO was (15.97±2.77) days, which was higher than that of WFDR (7.74±1.13) days (t=13.919, P<0.001). Questionnaire survey show that the scores of difficulty of mastering, color judgment of optic disc, authenticity of image color, three-dimensional image, clarity of peripheral retinopathy, crying degree of children during examination, and benefit to treatment in BIO were 8.78±0.84, 9.07±0.67, 9.09±0.69, 9.01±0.64, 7.33±0.93, 7.61±1.73, 6.57±1.11 respectively, which were higher than those of WFDR(6.07±1.06, 5.42±0.86, 7.40±0.70, 7.04±1.01, 5.88±1.06, 4.85±1.71, 4.47±0.92) (all P<0.001). The scores of suitable for large-scale screening, data preservation, and disease recognition in WFDR were 7.67±0.85, 8.97±0.68, 9.14±0.68 respectively, which were higher than those of BIO (4.90±0.84, 6.85±0.92, 3.16±0.73) (all P<0.001). Conclusion In the teaching of ROP, the wide field digital retinography is easier to master, with shorter examination time, more advantages in the diagnosis of ROP range. Binocular indirect ophthalmoscopy has more advantages in identification of ROP stage I and stage II. (Ophthalmol CHN, 2024, 33: 145-149)

Key words: retinopathy of prematurity, teaching