Eye Center, University of Freiburg, Freiburg, Germany.
Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany.
Acta Ophthalmol. 2016 Dec;94(8):e744-e752. doi: 10.1111/aos.13069. Epub 2016 May 20.
The German retinopathy of prematurity (ROP) Registry collects data on treated ROP in a multicentre approach to analyse epidemiology and treatment patterns of severe ROP.
Nine centres entered data from 90 treated ROP infants (born between January 2011 and December 2013) into a central database. Analysis included incidence rate of severe ROP, demographic data, stage of ROP, treatment patterns, recurrence rates, relevant comorbidities and ophthalmological or systemic complications associated with treatment.
Treatment rate for ROP was 3.2% of the screened population. The most frequent ROP stage at time of treatment was zone II, stage 3 + (137 eyes). Treatment was bilateral in 97% of infants. Treatment patterns changed over time from 7% anti-vascular endothelial growth factor (VEGF) monotherapy in 2011 to 32% in 2014. Overall, laser treatment was the predominant treatment. However, all infants with zone I disease received anti-VEGF treatment. About 19% of infants required retreatment (16% of laser-treated and 21% of anti-VEGF treated infants). Mean time between first and second treatment was 3.8 weeks (± 11 days) for laser-treated and 10.4 weeks (± 60 days) for anti-VEGF-treated infants.
This study is the first multicentre analysis of severe ROP in Germany. The identified treatment patterns find laser as the most prevalent form of therapy, with an increasing use of anti-VEGF therapy over recent years. Recurrence rates were relatively high overall with slightly higher recurrence rates and later recurrence times in the anti-VEGF group. Anti-VEGF was predominantly used for high-risk stages like AP-ROP and zone I disease.
德国早产儿视网膜病变(ROP)登记处采用多中心方法收集治疗 ROP 的数据,以分析严重 ROP 的流行病学和治疗模式。
9 个中心将 90 名接受治疗的 ROP 婴儿(出生于 2011 年 1 月至 2013 年 12 月之间)的数据输入中央数据库。分析包括严重 ROP 的发病率、人口统计学数据、ROP 分期、治疗模式、复发率、相关合并症以及与治疗相关的眼科或系统并发症。
ROP 的治疗率为筛查人群的 3.2%。治疗时最常见的 ROP 分期是二区,3+期(137 只眼)。97%的婴儿接受了双侧治疗。治疗模式随着时间的推移发生了变化,从 2011 年的 7%抗血管内皮生长因子(VEGF)单药治疗到 2014 年的 32%。总体而言,激光治疗是主要的治疗方法。然而,所有一区疾病的婴儿都接受了抗 VEGF 治疗。约 19%的婴儿需要再次治疗(激光治疗的婴儿中占 16%,抗 VEGF 治疗的婴儿中占 21%)。激光治疗的婴儿首次和第二次治疗之间的平均时间为 3.8 周(±11 天),抗 VEGF 治疗的婴儿为 10.4 周(±60 天)。
本研究是德国首次对严重 ROP 的多中心分析。所确定的治疗模式发现激光是最常见的治疗形式,近年来抗 VEGF 治疗的使用呈上升趋势。总体复发率相对较高,抗 VEGF 组的复发率和复发时间略高。抗 VEGF 主要用于高危阶段,如 AP-ROP 和一区疾病。