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[早产儿视网膜病变——接受二极管激光光凝治疗儿童的功能和结构转归]

[Retinopathy of prematurity--functional and structural outcome in children treated with diode laser photocoagulation].

作者信息

Petrinović-Doresić Jelena, Dorn Ljubica, Kuzmanović Biljana, Busić Mladen

机构信息

Klinika za ocne bolesti, Opća bolnica Sveti Duh, Zagreb, Hrvatska.

出版信息

Acta Med Croatica. 2006;60(2):153-8.

Abstract

AIM

To present the long-term structural and functional outcome of children treated with diode laser for retinopathy of prematurity.

PATIENTS AND METHODS

A total of six premature babies (12 eyes) in whom diode laser treatment was performed for acute retinopathy were followed up. The mean birth weight was 1185.0 +/- 309.6 g and mean gestational age was 28.5 +/- 1.87 weeks. Long term follow-up (18 to 41 months) included retinal examination, refractive status of the eye, and orthoptic evaluation: strabismus, amblyopia and nystagmus assessment.

RESULTS

Unfavorable structural outcome was detected in five eyes of six children (5/12 eyes, 41.7%). If only the eyes in no higher than threshold stage (3+) according to surgery records were taken in consideration (6/12 eyes), therapy resulted in favorable structural outcome in all six (100%) eyes. The mean spherical equivalent refractive error was -2.27 +/- 2.03 D (range -6.0 to +0.50 D). Profound amblyopia of one eye was found in five of six study children, and was invariably accompanied by heterotropia of the amblyopic eye: deviation in eso direction in three cases, and exodeviation and hypertropia in one case each. Nystagmus was present in four of six (66.6%) patients. All six children used vision as a dominant sense in space orientation and communication.

CONCLUSION

Diode laser therapy is a successful method in stopping and reversing the clinical course of severe retinopathy of prematurity, however only if timely implemented. The availability of this treatment modality in Croatia would significantly improve the structural and functional outcome of children with retinopathy.

摘要

目的

介绍接受二极管激光治疗早产儿视网膜病变的儿童的长期结构和功能转归。

患者与方法

对总共6名接受二极管激光治疗急性视网膜病变的早产儿(12只眼)进行随访。平均出生体重为1185.0±309.6克,平均胎龄为28.5±1.87周。长期随访(18至41个月)包括视网膜检查、眼睛屈光状态以及斜视检查评估:斜视、弱视和眼球震颤评估。

结果

6名儿童中的5只眼(5/12只眼,41.7%)出现不良结构转归。若仅考虑手术记录中不高于阈值阶段(3+)的眼睛(6/12只眼),则治疗使所有6只眼(100%)获得良好的结构转归。平均等效球镜屈光不正为-2.27±2.03 D(范围为-6.0至+0.50 D)。6名研究儿童中有5名一只眼存在重度弱视,且弱视眼总是伴有斜视:3例为内斜视,1例为外斜视,1例为上斜视。6名患者中有4名(66.6%)存在眼球震颤。所有6名儿童在空间定向和交流中均以视觉作为主导感觉。

结论

二极管激光治疗是阻止和逆转重度早产儿视网膜病变临床病程的一种成功方法,但前提是要及时实施。克罗地亚若能采用这种治疗方式将显著改善视网膜病变儿童的结构和功能转归。

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