Huang Qiujing, Zhang Qi, Xu Yu, Ji Xunda, Fei Ping, Peng Jie, Li Yi-An, Zhao Peiquan
Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Ophthalmol. 2017;2017:1741386. doi: 10.1155/2017/1741386. Epub 2017 Mar 29.
To present cases with retinopathy of prematurity (ROP), who were treated with intravitreal injection of ranibizumab (IVR) and had unpredictable asymmetric outcomes. A retrospective review was performed in infants with type 1 ROP and had bilateral IVR (0.25 mg/0.025 mL) as initial treatment. Patients were classified into the asymmetric outcome group and the symmetric outcome group. Eighty-four patients (168 eyes) were included. There were 18 eyes of 9 patients (10.7%) in the asymmetric outcome group and 150 eyes of 75 patients (89.3%) in the symmetric outcome group. In the symmetric outcome group, 86 eyes (57.3%) had ROP regression, 60 eyes (40%) had reactivation requiring laser treatment, and 4 eyes (2.7%) progressed to retinal detachment requiring vitrectomy. In the asymmetric outcome group, one of the eyes of the 9 patients had ROP regression with/without reactivation after IVR, while the contralateral eyes had negative response, including remarkable posterior fibrosis, partial or total retinal detachment, and vitreous hemorrhage. There was statistically significant difference between the birth weight of the two groups. Contralateral eyes with ROP can take a different clinical course after ranibizumab treatment. High rate of reactivation after IVR is another concern that ophthalmologists should pay attention to.
介绍接受玻璃体内注射雷珠单抗（IVR）治疗且结局不可预测的不对称性早产儿视网膜病变（ROP）病例。对1型ROP且初始治疗采用双侧IVR（0.25mg/0.025mL）的婴儿进行回顾性研究。将患者分为不对称结局组和对称结局组。共纳入84例患者（168只眼）。不对称结局组有9例患者的18只眼（10.7%），对称结局组有75例患者的150只眼（89.3%）。在对称结局组中，86只眼（57.3%）ROP消退，60只眼（40%）复发需要激光治疗，4只眼（2.7%）进展为视网膜脱离需要玻璃体切除术。在不对称结局组中，9例患者中的一只眼在IVR后ROP有消退伴或不伴复发，而对侧眼无反应，包括显著的后部纤维化、部分或完全视网膜脱离以及玻璃体出血。两组的出生体重有统计学显著差异。雷珠单抗治疗后，对侧ROP眼可能有不同的临床病程。IVR后高复发率是眼科医生应关注的另一个问题。
