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渗出性视网膜病变与视网膜脱离:玻璃体内注射贝伐单抗后早产儿视网膜病变的晚期复发

Exudative retinopathy and detachment: a late reactivation of retinopathy of prematurity after intravitreal bevacizumab.

作者信息

Ittiara Shaun, Blair Michael P, Shapiro Michael J, Lichtenstein Steven J

机构信息

Department of Surgery, Section of Ophthalmology and Visual Sciences, The University of Chicago, Chicago, Illinois, USA.

出版信息

J AAPOS. 2013 Jun;17(3):323-5. doi: 10.1016/j.jaapos.2013.01.004. Epub 2013 Apr 19.

Abstract

A 25-week postmenstrual age premature infant was treated with bilateral intravitreal bevacizumab for retinopathy of prematurity at 35 weeks' PMA. Postinjection, the retinal vessels progressed anteriorly within the retina. The patient presented 1 year after injection with bilateral exudative retinal detachments. The right eye was treated with intravitreal bevacizumab, laser ablation, and scleral buckling, resulting in resolution of the exudation and detachment. The left eye was treated with vitrectomy and lensectomy, but persistent exudation and detachment remained. This case demonstrates the rare complication of exudative retinal detachment in the setting of retinopathy of prematurity, which may become more common with increasing use of bevacizumab. Importantly, it also demonstrates the need not only for frequent examination after bevacizumab injection for retinopathy of prematurity but long-term follow-up as well, until either the retina is fully vascularized or peripheral ablation is performed.

摘要

一名孕龄25周的早产儿在孕龄35周时接受了双侧玻璃体内注射贝伐单抗治疗早产儿视网膜病变。注射后,视网膜血管在视网膜内向前进展。患者在注射后1年出现双侧渗出性视网膜脱离。右眼接受了玻璃体内注射贝伐单抗、激光光凝和巩膜扣带术治疗,渗出和脱离得以消退。左眼接受了玻璃体切除术和晶状体切除术,但仍存在持续性渗出和脱离。该病例显示了早产儿视网膜病变背景下渗出性视网膜脱离这一罕见并发症,随着贝伐单抗使用的增加,这种并发症可能会变得更加常见。重要 的是,它还表明,对于早产儿视网膜病变,不仅在注射贝伐单抗后需要频繁检查,还需要长期随访,直到视网膜完全血管化或进行周边光凝。

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