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[早产儿视网膜病变活动期的二极管治疗结果]

[The results of diode treatment of active phase of retinopathy of prematurity].

作者信息

Gotz-Wieckowska Anna, Kociecki Jarosław, Burchardt-Kroll Ewa, Gadzinowski Janusz

机构信息

Katedry i Kliniki Okulistyki Akademii Medycznej w Poznaniu.

出版信息

Klin Oczna. 2003;105(6):395-7.

Abstract

PURPOSE

  1. The results of diode laser treatment of active phase of retinopathy of prematurity. 2. Determination of risk factors influencing results of treatment. 3. Determination of coexistence frequency with other chronic diseases subsequent to ROP, like broncho-pulmonary dysplasia, hydrocephalus and periventricular leucomalacia.

PATIENTS AND METHOD

27 premature infants were treated with an aid of diode laser since June to December 2002. Birth weight varied from 550 to 1600 g (mean 941.85 g) and gestational age from 25 to 32 weeks (mean Hbd 27.6). In 6 premature infants (12 eyes) ROP was stated in the I zone. In 14 premature infants (28 eyes) threshold ROP was found in II zone. In 2 premature infants (3 eyes) threshold ROP diagnosed in III zone and in 5 premature infants (10 eyes) wide fibro-vascular proliferations were found in the area exceeding 12 hours. Treatment was performed with an aid of diode laser OcuLight SLx from the company IRIS Medical Instruments, Inc., emitting infrared radiation (810 nm).

RESULTS

Good anatomical results were obtained in 17 cases (36 eyes), in 3 cases (5 eyes) macular ectopy, in 2 cases (3 eyes) partial retinal detachment and in 5 cases (10 eyes) total retinal detachment. Only in 4 children ROP occurred as a late complication of prematurity.

CONCLUSIONS

  1. Obtained results of treatment with an aid of diode laser depend on localization of lesions, occurring in course of ROP and on the stage of its advancement. Treatment performed in premature infants in active phase, threshold ROP in the II-nd and III-rd zone causes good anatomical results. 2. The cause of treatment failure was localization of ROP in the I-st zone, accompanied by rapid course or wide fibro-vascular proliferations exceeding 12 hours. 3. Children with diagnosed retinopathy are at high risk of psycho-motoric disturbance because of other chronic disorders, that may often coexist.
摘要

目的

  1. 二极管激光治疗早产儿视网膜病变活动期的结果。2. 确定影响治疗结果的危险因素。3. 确定ROP之后与其他慢性疾病(如支气管肺发育不良、脑积水和脑室周围白质软化症)共存的频率。

患者与方法

2002年6月至12月期间,27例早产儿接受了二极管激光治疗。出生体重从550克至1600克不等(平均941.85克),胎龄从25周至32周不等(平均27.6周)。6例早产儿(12只眼)的ROP位于I区。14例早产儿(28只眼)在II区发现阈值ROP。2例早产儿(3只眼)在III区诊断出阈值ROP,5例早产儿(10只眼)在超过12小时的区域发现广泛的纤维血管增殖。使用IRIS Medical Instruments, Inc.公司的二极管激光OcuLight SLx进行治疗,该激光发射红外辐射(810纳米)。

结果

17例(36只眼)获得了良好的解剖学结果,3例(5只眼)出现黄斑异位,2例(3只眼)出现部分视网膜脱离,5例(10只眼)出现完全视网膜脱离。只有4例儿童的ROP作为早产的晚期并发症出现。

结论

  1. 使用二极管激光获得的治疗结果取决于ROP病程中病变的位置及其进展阶段。在活动期对早产儿进行治疗,II区和III区的阈值ROP可产生良好的解剖学结果。2. 治疗失败的原因是ROP位于I区,伴有病程快速或超过12小时的广泛纤维血管增殖。3. 由于其他慢性疾病常常共存,患有视网膜病变的儿童存在精神运动障碍的高风险。

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