Morrison David, Shaffer James, Ying Gui-Shuang, Binenbaum Gil
Vanderbilt University Medical Center, Nashville Tennessee.
Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
J AAPOS. 2018 Apr;22(2):128-133. doi: 10.1016/j.jaapos.2017.12.005. Epub 2018 Mar 14.
To determine the prevalence of treatment-related ocular complications and disease progression following treatment for retinopathy of prematurity (ROP).
This was a retrospective cohort study of eyes treated for ROP at 29 North American neonatal intensive care units in the Postnatal Growth and ROP (G-ROP) Study. Data from the time of treatment through 15 months were abstracted from medical records by certified data collectors. Treatment-related complication (cataract, hyphema, glaucoma, corneal abrasion/opacity), and disease-progression (retinal fold, dragging, or stage 4 or 5 detachment) were calculated by treatment modality. Vitreous hemorrhage was classified separately, because it can relate to treatment or disease progression.
Of 7,483 infants included in the study, 1,004 eyes (512 infants) underwent ROP treatment: 970 eyes received laser as initial therapy; 34 eyes received intravitreal bevacizumab (IVB). Median follow-up after treatment was 18 weeks. Overall, one or more complications occurred in 2.6% (95% CI, 1.8%-3.8%) laser treated eyes and no (0%; 95% CI, 0.0%-10.1%) IVB eyes. Disease-progression occurred in 9.2% (95% CI, 7.6%-11.2%) laser treated eyes, no (0%; 95% CI, 0.0-12.9%) IVB-only eyes. Vitreous hemorrhage occurred in 5.4% (95% CI: 4.1% - 7.0%) laser treated eyes, no IVB-only eyes.
Rates of complications are very low following ROP treatment with either laser or IVB. Of laser-treated eyes, 9% experienced disease progression despite treatment.
确定早产儿视网膜病变(ROP)治疗后与治疗相关的眼部并发症及疾病进展的发生率。
这是一项对北美29个新生儿重症监护病房接受ROP治疗的眼睛进行的回顾性队列研究,该研究纳入了产后生长与ROP(G-ROP)研究。经认证的数据收集人员从医疗记录中提取从治疗时起至15个月的数据。根据治疗方式计算与治疗相关的并发症(白内障、前房积血、青光眼、角膜擦伤/混浊)及疾病进展(视网膜皱襞、牵拉或4期或5期视网膜脱离)。玻璃体出血单独分类,因为其可能与治疗或疾病进展有关。
在纳入研究的7483例婴儿中,1004只眼(512例婴儿)接受了ROP治疗:970只眼接受激光作为初始治疗;34只眼接受玻璃体内注射贝伐单抗(IVB)。治疗后的中位随访时间为18周。总体而言,接受激光治疗的眼睛中有2.6%(95%CI,1.8%-3.8%)发生了一种或多种并发症,而接受IVB治疗的眼睛未发生并发症(0%;95%CI,0.0%-10.1%)。接受激光治疗的眼睛中有9.2%(95%CI,7.6%-11.2%)出现疾病进展,仅接受IVB治疗的眼睛未出现疾病进展(0%;95%CI,0.0-12.9%)。接受激光治疗的眼睛中有5.4%(95%CI:4.1%-7.0%)发生玻璃体出血,仅接受IVB治疗的眼睛未发生玻璃体出血。
激光或IVB治疗ROP后的并发症发生率非常低。在接受激光治疗的眼睛中,9%的眼睛尽管接受了治疗仍出现了疾病进展。