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早产儿视网膜病变的非典型形式,伴有严重的纤维血管增生,发生于视盘区域。

ATYPICAL FORM OF RETINOPATHY OF PREMATURITY WITH SEVERE FIBROVASCULAR PROLIFERATION IN THE OPTIC DISK REGION.

机构信息

Department of Ophthalmology and Laboratory for Visual Science, National Center for Child Health and Development, Tokyo, Japan.

Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Retina. 2018 Aug;38(8):1605-1612. doi: 10.1097/IAE.0000000000001779.

Abstract

PURPOSE

To describe severe fibrovascular proliferation that developed in the optic disk region in an atypical form of retinopathy of prematurity (ROP).

METHODS

Retrospective observational case reports.

RESULTS

Four patients (8 eyes) with ROP were included. Three patients were born very prematurely (24-25 weeks of gestational age; weight, 500-1,000 grams); 1 patient was born at 33 weeks of gestational age. Among all eight eyes of four patients who received prompt ROP screening and underwent laser photocoagulation, six eyes had atypical and severe fibrovascular proliferation mainly in the optic disk region; the other two eyes, including one eye with classic ROP and one eye with aggressive posterior ROP, did not have the atypical form. All eight eyes had a total to partial retinal detachment. Among the six eyes with the atypical form, early vitreous surgery with lensectomy was possible in three eyes; only late vitreous surgery with lensectomy was possible in two eyes; one eye was inoperable. Three eyes had a partial or complete reattachment, whereas three eyes had a total retinal detachment. Among the six eyes with atypical fibrovascular proliferation, only two eyes obtained light perception vision.

CONCLUSION

An atypical and severe form of ROP, in which fibrovascular proliferation grew mainly from the optic disk region, needs further investigation for treatment in addition to laser photocoagulation and vitreous surgery.

摘要

目的

描述一种早产儿视网膜病变(ROP)的非典型形式,其在视盘区域出现严重的纤维血管增生。

方法

回顾性观察病例报告。

结果

纳入了 4 名(8 只眼)ROP 患者。3 名患者出生极早(孕 24-25 周;体重 500-1000 克);1 名患者孕 33 周出生。在所有 8 只接受及时 ROP 筛查并接受激光光凝治疗的患者眼中,6 只眼主要在视盘区域出现非典型和严重的纤维血管增生;另两只眼,包括一只经典 ROP 眼和一只侵袭性后部 ROP 眼,没有非典型形式。所有 8 只眼均出现全视网膜或部分视网膜脱离。在 6 只具有非典型形式的眼中,3 只眼可早期行玻璃体切除术联合晶状体切除术;2 只眼仅可行晚期玻璃体切除术联合晶状体切除术;1 只眼无法手术。3 只眼部分或完全复位,3 只眼全视网膜脱离。在 6 只出现非典型纤维血管增生的眼中,仅有 2 只眼获得光感视力。

结论

除激光光凝和玻璃体手术外,还需要进一步研究治疗这种非典型且严重的 ROP 形式,其纤维血管增生主要从视盘区域生长。

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