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贝伐单抗与激光治疗侵袭性早产儿视网膜病变后的消退率:8年回顾性分析

Regression Rates Following the Treatment of Aggressive Posterior Retinopathy of Prematurity with Bevacizumab Versus Laser: 8-Year Retrospective Analysis.

作者信息

Nicoară Simona D, Ștefănuţ Anne C, Nascutzy Constanta, Zaharie Gabriela C, Toader Laura E, Drugan Tudor C

机构信息

Department of Ophthalmology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Department of Ophthalmology, Emergency County Hospital, Cluj-Napoca, Romania.

出版信息

Med Sci Monit. 2016 Apr 10;22:1192-209. doi: 10.12659/msm.897095.

Abstract

BACKGROUND Retinopathy is a serious complication related to prematurity and a leading cause of childhood blindness. The aggressive posterior form of retinopathy of prematurity (APROP) has a worse anatomical and functional outcome following laser therapy, as compared with the classic form of the disease. The main outcome measures are the APROP regression rate, structural outcomes, and complications associated with intravitreal bevacizumab (IVB) versus laser photocoagulation in APROP. MATERIAL AND METHODS This is a retrospective case series that includes infants with APROP who received either IVB or laser photocoagulation and had a follow-up of at least 60 weeks (for the laser photocoagulation group) and 80 weeks (for the IVB group). In the first group, laser photocoagulation of the retina was carried out and in the second group, 1 bevacizumab injection was administered intravitreally. The following parameters were analyzed in each group: sex, gestational age, birth weight, postnatal age and postmenstrual age at treatment, APROP regression, sequelae, and complications. Statistical analysis was performed using Microsoft Excel and IBM SPSS (version 23.0). RESULTS The laser photocoagulation group consisted of 6 premature infants (12 eyes) and the IVB group consisted of 17 premature infants (34 eyes). Within the laser photocoagulation group, the evolution was favorable in 9 eyes (75%) and unfavorable in 3 eyes (25%). Within the IVB group, APROP regressed in 29 eyes (85.29%) and failed to regress in 5 eyes (14.71%). These differences are statistically significant, as proved by the McNemar test (P<0.001). CONCLUSIONS The IVB group had a statistically significant better outcome compared with the laser photocoagulation group, in APROP in our series.

摘要

背景

视网膜病变是与早产相关的一种严重并发症,也是儿童失明的主要原因。与经典型早产儿视网膜病变相比,侵袭性后部型早产儿视网膜病变(APROP)在激光治疗后的解剖和功能预后更差。主要观察指标为APROP的消退率、结构预后以及玻璃体内注射贝伐单抗(IVB)与激光光凝治疗APROP相关的并发症。

材料与方法

这是一项回顾性病例系列研究,纳入接受IVB或激光光凝治疗且随访至少60周(激光光凝组)和80周(IVB组)的APROP婴儿。第一组进行视网膜激光光凝治疗,第二组玻璃体内注射1次贝伐单抗。对每组分析以下参数:性别、胎龄、出生体重、治疗时的生后年龄和月经后年龄、APROP消退情况、后遗症和并发症。使用Microsoft Excel和IBM SPSS(23.0版)进行统计分析。

结果

激光光凝组包括6例早产儿(12只眼),IVB组包括17例早产儿(34只眼)。在激光光凝组中,9只眼(75%)病情好转,3只眼(25%)病情不佳。在IVB组中,29只眼(85.29%)的APROP消退,5只眼(14.71%)未消退。经McNemar检验证明,这些差异具有统计学意义(P<0.001)。

结论

在我们的系列研究中,对于APROP,IVB组的预后在统计学上显著优于激光光凝组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8ad/4918525/2e54f11faee6/medscimonit-22-1192-g001.jpg

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