Odehnal M, Malec J, Hlozánek M, Dotrelová D
Ocní klinika detí a dospélých UK 2 LF a FN Motol, Praha.
Cesk Slov Oftalmol. 2006 Sep;62(5):316-23.
The goal of this clinical trial was to evaluate outcomes of the treatment of retinopathy of prematurity (ROP) located in zone 1 (Zone 1 ROP). This disease has a specific clinical appearance and poor prognosis. Usually it is difficult to identify particular stages of ROP and to indicate treatment while following progression of the disease. In the group of zone 1 ROP it is necessary to separate transient forms (TF), in which vascularizations reach edges of zone 2, from very posterior forms (VPR), in which vascularizations and pathological changes are present only in zone 1. There were 24 eyes with zone 1 ROP (15 children) treated with combination of transcleral laser photocoagulation and cryotherapy during the years 2000 till 2005 in our series. Five eyes suffered from VPR, 19 eyes from TF. Average follow -up was 24 months. We found better outcomes in eyes with TF treated in pre-threshold stage of ROP (10 eyes) than in threshold stage of ROP (9 eyes). All 5 eyes with VPR developed unfavourable ROP stage IV or V. Zone 1 ROP becomes diagnostic and therapeutic challenge considering growing incidence of surviving of newborns with low or very low birth weight. Treatment initiation during prethreshold stage of ROP as it is supported by ETROP study (Early treatment of ROP) seems to be promising.
这项临床试验的目的是评估位于1区的早产儿视网膜病变(ROP,1区ROP)的治疗效果。这种疾病有特定的临床表现且预后较差。通常,在追踪疾病进展过程中,很难确定ROP的特定阶段并指明治疗时机。在1区ROP组中,有必要将血管化到达2区边缘的短暂性病变形式(TF)与仅在1区存在血管化和病理变化的极后部病变形式(VPR)区分开来。在我们的系列研究中,2000年至2005年期间,有24只患有1区ROP的眼睛(15名儿童)接受了经巩膜激光光凝和冷冻疗法联合治疗。其中5只眼睛患有VPR,19只眼睛患有TF。平均随访时间为24个月。我们发现,在ROP阈值前期接受治疗的TF眼睛(10只)的治疗效果优于ROP阈值期(9只)。所有5只患有VPR的眼睛均发展为不良的ROP Ⅳ期或Ⅴ期。考虑到低出生体重或极低出生体重新生儿存活率的不断上升,1区ROP成为了诊断和治疗上的挑战。正如ROP早期治疗(ETROP)研究所支持的那样,在ROP阈值前期开始治疗似乎很有前景。