Tran Kimberly D, Cernichiaro-Espinosa Linda A, Berrocal Audina M
Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Asia Pac J Ophthalmol (Phila). 2018 Jan-Feb;7(1):56-62. doi: 10.22608/APO.2017436. Epub 2018 Jan 26.
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide. Although laser photocoagulation re-mains the gold standard for treating threshold and prethreshold disease (type 1 ROP), the off-label use of anti‒vascular endothelial growth factor (anti-VEGF) therapy to treat ROP is increasing. Benefits include acute regression of ROP, growth of retinal vasculature beyond the demarcation line, lesser degree of myopia and peripheral visual field loss, and avoidance of sedation and intubation required for laser. However, controversies regarding anti-VEGF in this vulnerable population persist including choice of anti-VEGF agent, dosing, systemic absorption, safety, and late recurrence. This review updates recent evidence regarding the use of anti-VEGF therapy in the management of ROP.
早产儿视网膜病变(ROP)是全球儿童失明的主要原因。尽管激光光凝仍然是治疗阈值期和阈值前期疾病(1型ROP)的金标准,但抗血管内皮生长因子(anti-VEGF)疗法在ROP治疗中的非适应证使用正在增加。其益处包括ROP急性消退、视网膜血管越过分界线生长、近视程度减轻和周边视野丧失减少,以及避免激光治疗所需的镇静和插管。然而,在这个脆弱人群中,关于抗VEGF的争议仍然存在,包括抗VEGF药物的选择、剂量、全身吸收、安全性和晚期复发。本综述更新了关于抗VEGF疗法在ROP管理中应用的最新证据。