目的：探讨早产儿视网膜病变(ROP)自然退行的临床特征、时间进程及其相关影响因素。

方法：回顾性分析ROP患儿的临床资料，系统评估不同严重程度ROP的自然退行率及退行过程，并分析影响ROP自然退行的潜在因素。

结果：最终ROP患儿138例138眼(双眼病例选择病情较重眼)纳入分析，其中男77例，女61例。平均胎龄为30.0±2.3 wk，113例ROP患儿出现自然退行。1、2、3期ROP的自然退行率分别为100%、81%和23%。Ⅲ区ROP退行率为100%，Ⅱ区ROP为74%，而Ⅰ区ROP及伴有附加病变(plus病变)者均未见退行。胎龄和出生体质量越高，自然退行率越高。ROP开始退行时的矫正胎龄(PMA)中位数为39.8 wk，退行完成时PMA中位数为48.4 wk，退行持续时间的中位数为8 wk。Ⅱ区ROP及较高期别(≥2期)ROP的退行起始时间更晚、退行完成的时间更迟、退行持续时间更长。进一步分析显示，机械通气时间>14 d及存在视网膜出血是妨碍ROP退行的危险因素。

结论：ROP自然退行率因病变分期、分区、胎龄及出生体质量不同而存在差异，1期及Ⅲ区ROP的自然退行率高，而2期、Ⅱ区及更严重的ROP退行率降低，仍需密切监测或积极干预。ROP自然退行时间进程亦随病变分期和分区的不同而变化。机械通气时间>14 d及视网膜出血是妨碍ROP退行的危险因素。

METHODS: A retrospective analysis was conducted on clinical data from infants diagnosed with ROP. The clinical outcomes were systematically evaluated, including the rates and process of spontaneous regression across different ROP stages and zones. Potential factors for spontaneous regression were also examined.

RESULTS: A total of 138 infants(138 eyes, for patients with bilateral involvement, the more severely affected eye was chosen)with ROP were included, consisting of 77 males and 61 females. The mean gestational age was 30.0±2.3 wk. Spontaneous regression was observed in 113 cases. The regression rates for stages 1, 2, and 3 were 100%, 81%, and 23%, respectively. Regression was observed in 100% of zone Ⅲ cases and 74% of zone II cases, but did not occur in zone I or in cases with plus disease. Higher gestational age and birth weight were associated with increased rates of spontaneous regression. The median postmenstrual age(PMA)at the onset of ROP regression was 39.8 wk and at the completion of regression was 48.4 wk, with a median regression duration of 8 wk. Zone II and higher-stage ROP(stages≥2)were associated with a later onset and completion of regression, as well as a longer regression duration. Further analysis revealed that mechanical ventilation duration>14 d and retinal hemorrhage were identified as risk factors impeding the spontaneous regression of ROP.

CONCLUSION: The spontaneous regression rate of ROP varies with stage, zone, gestational age, and birth weight. The regression rate is high for stage 1 and zone Ⅲ ROP, whereas it is lower for stage 2, zone II, and more severe forms of ROP, which require close monitoring or active intervention. The time course of spontaneous regression of ROP also differs by disease stage and zone.Mechanical ventilation lasting>14 d and retinal hemorrhage are risk factors impeding the spontaneous regression of ROP.