目的：探讨高危新生儿视网膜黄斑出血与屈光异常的关系，并分析屈光发育异常的影响因素。

方法：对2017-01/2018-01在我院新生儿科住院的高危新生儿1 229例2 458眼于出生后7d内进行RetCamⅢ眼底照像检查，并于1～1.5岁进行屈光筛查，分析高危新生儿屈光发育异常的影响因素。

结果：本研究纳入高危新生儿中视网膜出血未累及黄斑者205眼(A组)，其中屈光异常者6眼(2.93%)； 视网膜出血累及黄斑者57眼(B组)，其中屈光异常者17眼(29.82%)； 无视网膜出血者2 196眼(C组)，其中屈光异常者40眼(1.82%)，B组患儿屈光异常率高于A组和C组(均P<0.001)，而A组与C组之间无差异(P=0.27)。Logistic回归分析结果显示，黄斑出血、缺血缺氧性脑病是屈光发育异常的独立危险因素。

结论：视网膜黄斑区出血的新生儿中屈光发育异常率较高，黄斑出血和缺血缺氧性脑病是导致屈光发育异常的独立危险因素，应针对此类新生儿群体加强观察和干预。

METHODS: From January 2017 to January 2018, a total of 1 229 neonates with high-risk factors invided into 3 groups, according to the different parts of retinal hemorrhage, examined by RetCamⅢ device. All the subjects were checked the refractive status by autorefractor when they were 1 to 1.5 years old. The abnormalities were checked their refractive status under using of 1% atropine oculentum after 7d. The relationship between the macular hemorrhage and refractive abnormalities, and the occurrence probability and the factors of refractive abnormalities were analyzed.

RESULTS: Among 205 eyes which were retinal hemorrhage irrelated macula 6 eyes had refractive abnormality(2.93%)in group A. 57 eyes which were macular hemorrhage 17 eyes had refractive abnormality(29.82%)in group B. 2 196 eyes which were no retinal hemorrhage 40 eyes had refractive abnormality(1.82%)in group C. It had significant difference between groups A and B, groups B and C(P<0.001), but had no significant difference between groups A and C(P=0.27). Multivariate Logistic regression analysis showed that macular hemorrhage and neonatal hypoxic ischemic encephalopathy were the independent risk factors for refractive status.

CONCLUSION: The incidence of refractive abnormality was high in macular hemorrhage. Macular hemorrhage and neonatal hypoxic ischemic encephalopathy were the independent risk factors for refractive abnormality,and we should strengthen the observation and intervention of such new-borns.