Axer-Siegel Ruth, Maharshak Idit, Snir Moshe, Friling Ronit, Ehrlich Rita, Sherf Ilana, Shalev Benjamin, Sirota Lea, Weinberger Dov
Department of Ophthalmology, Rabin Medical Center, Tel Aviv, Israel.
Retina. 2008 Jun;28(6):839-46. doi: 10.1097/IAE.0b013e318169faee.
To examine the anatomical and refractive outcomes of infrared diode laser photocoagulation (DLPC) for the treatment of threshold retinopathy of prematurity (ROP).
The charts of all consecutive premature neonates with ROP treated by DLPC at our tertiary center from December 1, 1996, to December 31, 2004, were reviewed.
The group included 100 neonates (194 eyes) with a mean birth weight +/- SD of 833.9 +/- 250.3 g and a mean gestational age +/- SD of 26 +/- 1.9 weeks. Sixty-two percent of neonates had zone I or posterior zone II ROP. Each eye received a mean +/- SD of 1,740 +/- 990 laser applications, and 21% of eyes received an additional 1 to 2 rows posterior to the ridge. Neonates treated after December 2003 (cutoff date of the Early Treatment of Retinopathy of Prematurity study) underwent a significantly greater number of laser applications (mean +/- SD, 2,286 +/- 1,087) than did neonates treated earlier. Anatomical results of laser treatment were favorable for 179 eyes (92.3%) at a mean follow-up +/- SD of 33.6 +/- 27.2 months. After vitreoretinal surgery, partial or total retinal detachment was documented for 2.5% of patients who received posterior-to-the-ridge laser treatment and 3.8% of patients treated only on the avascular retina. Refractive data were available for 134 eyes: 55.2% had myopia of -5 diopters (31.3%) or greater (23.9%). Strabismus was found in 21 (28.8%) of 73 neonates tested. Gestational age was correlated with corrected age at treatment, zone of ROP, number of laser applications, and spherical equivalent. Snellen visual acuity of 6/12 or more occurred in 17 of 24 patients who complied with testing.
DLPC is a safe and effective treatment for ROP. Neonates of lower gestational age and birth weight require earlier and more aggressive laser treatment and may have a higher refractive error.
探讨红外二极管激光光凝术（DLPC）治疗阈值性早产儿视网膜病变（ROP）的解剖学和屈光结果。
回顾了1996年12月1日至2004年12月31日在我们三级中心接受DLPC治疗的所有连续性ROP早产儿的病历。
该组包括100例新生儿（194只眼），平均出生体重±标准差为833.9±250.3g，平均胎龄±标准差为26±1.9周。62%的新生儿患有I区或后II区ROP。每只眼平均接受±标准差为1740±990次激光照射，21%的眼睛在嵴后额外接受1至2排照射。2003年12月（早产儿视网膜病变早期治疗研究的截止日期）之后接受治疗的新生儿接受的激光照射次数（平均±标准差，2286±1087）明显多于早期接受治疗的新生儿。在平均随访±标准差为33.6±27.2个月时，179只眼（92.3%）的激光治疗解剖学结果良好。玻璃体视网膜手术后，接受嵴后激光治疗的患者中有2.5%记录有部分或完全视网膜脱离，仅在无血管视网膜上接受治疗的患者中有3.8%出现这种情况。有134只眼的屈光数据可用：55.2%有-5屈光度（31.3%）或更高度数（23.9%）的近视。在接受测试的73例新生儿中，有21例（28.8%）发现斜视。胎龄与治疗时的矫正年龄、ROP区域、激光照射次数和等效球镜相关。在24例接受检查的患者中，17例的Snellen视力达到6/12或更好。
DLPC是治疗ROP的一种安全有效的方法。胎龄和出生体重较低的新生儿需要更早、更积极的激光治疗，且可能有更高的屈光不正。
