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早产儿视网膜病变I区:临床特征与治疗结果

Zone I retinopathy of prematurity: clinical characteristics and treatment outcomes.

作者信息

Kychenthal Andres, Dorta Paola, Katz Ximena

机构信息

Hospital de Niños Roberto del Río, Santiago, Chile.

出版信息

Retina. 2006 Sep;26(7 Suppl):S11-5. doi: 10.1097/01.iae.0000244285.79004.e6.

Abstract

PURPOSE

To study the clinical characteristics and treatment outcomes after laser and surgical treatment in a series of infants with zone I retinopathy of prematurity (ROP).

METHODS

Preterm infants less than 1,500 g at birth diagnosed with zone I ROP were studied. Fifty-seven consecutive eyes in 29 infants with zone I ROP were treated with indirect diode laser. Within zone I, two anatomic subgroups (anterior and posterior) were defined. Additionally, 27 eyes (15 patients) with retinal detachment secondary to zone I ROP were surgically treated. Structural outcomes were evaluated 3 months after surgery.

RESULTS

Atypical morphologic characteristics were observed. Thirty-one out of 48 eyes (64.6%) with anterior zone I ROP and none of the 9 eyes with posterior zone I ROP had a favorable outcome (P < 0.001) after photocoagulation. In the surgery group, 14 out of 19 (74%) eyes with stage 4 and 1 out of 8 (13%) eyes with stage 5 had favorable outcomes.

CONCLUSIONS

Atypical clinical features can be observed in zone I ROP. A posterior localization of the disease carries a worse prognosis after laser photocoagulation. Surgical intervention can effectively reattach the retina in a significant number of zone I ROP-related retinal detachments.

摘要

目的

研究一系列I区早产儿视网膜病变(ROP)患儿接受激光和手术治疗后的临床特征及治疗效果。

方法

对出生体重小于1500g且诊断为I区ROP的早产儿进行研究。29例I区ROP患儿的57只眼接受了间接二极管激光治疗。在I区内,定义了两个解剖亚组(前部和后部)。此外,对27只因I区ROP继发视网膜脱离的眼睛(15例患者)进行了手术治疗。术后3个月评估结构结果。

结果

观察到非典型形态学特征。I区前部ROP的48只眼中有31只(64.6%)光凝后预后良好,I区后部ROP的9只眼中无一例预后良好(P<0.001)。手术组中,4期的19只眼中有14只(74%)、5期的8只眼中有1只(13%)预后良好。

结论

I区ROP可观察到非典型临床特征。疾病的后部定位在激光光凝后预后较差。手术干预可有效使大量与I区ROP相关的视网膜脱离复位。

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