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早产儿视网膜病变诊断与治疗的新见解。

New insights in diagnosis and treatment for Retinopathy of Prematurity.

作者信息

Cernichiaro-Espinosa Linda A, Olguin-Manriquez Francisco J, Henaine-Berra Andree, Garcia-Aguirre Gerardo, Quiroz-Mercado Hugo, Martinez-Castellanos Maria A

机构信息

Retina Department, Hospital General Dr. Manuel Gea González, México, DF, Mexico.

Retina Department, Asociación para Evitar la Ceguera en México, IAP, Vicente Garcia Torres No. 46 Coyoacan, México, DF, Mexico.

出版信息

Int Ophthalmol. 2016 Oct;36(5):751-60. doi: 10.1007/s10792-016-0177-8. Epub 2016 Jan 14.

Abstract

The purpose of this study was to review current perspectives on diagnosis and treatment of Retinopathy of Prematurity (ROP). We performed a systematic review of how much has been produced in research published online and on print regarding ROP in different settings around the world. Early Treatment for ROP (ETROP) classification is the currently accepted classification of ROP. Fluorescein angiography and spectral domain optical coherence tomography (SD-OCT) may eventually lead to changes in the definition of ROP, and as a consequence, they will serve as a guide for treatment. Intravitreal anti-VEGF therapy has proven to be more effective in terms of lowering recurrence, allowing growth of the peripheral retina, and diminishing the incidence of retinal detachment when proliferative ROP is diagnosed. Whether anti-VEGF plus laser are better than any of these therapies separately remains a subject of discussion. Telemedicine is evolving everyday to allow access to remote areas that do not count with a retina specialist for treatment. A management algorithm is proposed according to our reference center experience. ROP is an evolving subject, with a vulnerable population of study that, once treated with good results, leads to a reduction in visual disability and in consequence, in a lifetime improvement.

摘要

本研究的目的是回顾当前关于早产儿视网膜病变(ROP)诊断和治疗的观点。我们对全球不同地区在线和印刷出版的有关ROP的研究成果进行了系统综述。早期治疗早产儿视网膜病变(ETROP)分类是目前公认的ROP分类。荧光素血管造影和光谱域光学相干断层扫描(SD - OCT)最终可能会导致ROP定义的改变,因此,它们将作为治疗的指导。玻璃体内抗VEGF治疗已被证明在降低复发率、促进周边视网膜生长以及减少增殖性ROP诊断时视网膜脱离的发生率方面更有效。抗VEGF联合激光治疗是否比单独使用这些治疗方法中的任何一种更好仍存在争议。远程医疗正在不断发展,以便为没有视网膜专科医生的偏远地区提供治疗途径。根据我们参考中心的经验提出了一种管理算法。ROP是一个不断发展的课题,其研究对象较为脆弱,一旦得到良好治疗,可减少视力残疾,从而改善一生的生活质量。

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