Henaine-Berra Andree, Garcia-Aguirre Gerardo, Quiroz-Mercado Hugo, Martinez-Castellanos Maria Ana
Retina Department, Asociacion Para Evitar la Ceguera en Mexico, I.A.P. Hospital "Dr. Luis Sanchez Bulnes", Coyoacan, Mexico City.
Ophthalmology Department, Denver Health Medical Center, School of Medicine, University of Colorado, Denver, CO.
J AAPOS. 2014 Apr;18(2):120-3. doi: 10.1016/j.jaapos.2013.12.009.
To describe the retinal vascular morphology in eyes injected with intravitreal bevacizumab for treatment-requiring retinopathy of prematurity (ROP).
In this prospective, nonrandomized case series, fundus photographs and fluorescein angiography in patients diagnosed with stage 3 threshold or prethreshold ROP, were obtained immediately before and 1 month after injection of 0.03 cc (0.75 mg) of intravitreal bevacizumab using wide-field digital pediatric imaging system.
A total of 47 eyes of 26 patients were included. Before treatment, fluorescein angiography showed vascular abnormalities, including capillary nonperfusion throughout and shunting in the vascularized retina, demarcation line, limited vessel development, new vessels leakage, avascular periphery and absence of foveal avascular zone. After intravitreal bevacizumab, fluorescein angiography showed involution of the neovascularization, flattening of the demarcation line and subsequent growth of vessels to the capillary-free zones. During the following weeks large areas devoid of microvessels were seen as well as vascular remodeling with uneven spacing of the retinal capillaries and vascular loops in the areas that were previously devoid of vessels. In some patients, retinal vessels in the far periphery never developed: patients with these findings did not subsequently develop pathological neovascularization.
In this study cohort, patients showed improvement of their abnormal vascular findings after intravitreal bevacizumab, however even when the vascular pattern remained abnormal, there was creation of small vessels, establishment of directional flow, maturation of retinal vessels, and adjustment of vascular density.
描述玻璃体内注射贝伐单抗治疗需要治疗的早产儿视网膜病变（ROP）时的视网膜血管形态。
在这个前瞻性、非随机病例系列中，使用广角数字儿科成像系统，在诊断为3期阈值或阈值前ROP的患者中，于注射0.03 cc（0.75 mg）玻璃体内贝伐单抗之前及之后1个月立即获取眼底照片和荧光素血管造影图像。
共纳入26例患者的47只眼。治疗前，荧光素血管造影显示血管异常，包括整个区域的毛细血管无灌注、血管化视网膜中的分流、分界线、血管发育受限、新生血管渗漏、无血管周边以及黄斑无血管区缺失。玻璃体内注射贝伐单抗后，荧光素血管造影显示新生血管消退、分界线变平以及随后血管向无毛细血管区生长。在接下来的几周内，可见大片无微血管区域以及视网膜毛细血管间距不均和血管环的血管重塑，这些区域之前无血管。在一些患者中，最周边的视网膜血管从未发育：有这些发现的患者随后未发生病理性新生血管形成。
在本研究队列中，患者在玻璃体内注射贝伐单抗后异常血管表现有所改善，然而即使血管模式仍异常，仍有小血管形成、方向血流建立、视网膜血管成熟以及血管密度调整。
