Stahl Andreas
Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Killianstraße 5, 79106, Freiburg, Deutschland.
Ophthalmologe. 2018 Jun;115(6):456-463. doi: 10.1007/s00347-018-0720-2.
The treatment of retinopathy of prematurity (ROP) has gained a new dynamic since the introduction of anti-vascular endothelial growth factor (VEGF) therapy. This review summarizes clinical trial data in order to aid informed decision-making.
In this article, pivotal clinical trials are summarized and discussed with regard to their implications for ROP therapy.
The longest follow-up phase exists for children treated in the CRYO-ROP study, which used retinal cryocoagulation to treat ROP. Based on results of the ETROP study and others, retinal laser therapy has replaced cryotherapy as standard of care. For anti-VEGF treatment, three controlled clinical trials exist to date: BEAT-ROP, CARE-ROP, and the PEDIG study. Combined, these studies demonstrate efficacy of anti-VEGF in treating acute ROP. However, they also emphasize the risk of (late) recurrences and the largely unsolved questions regarding choice of drug and dose as well as long-term safety.
Treatment of ROP remains a highly individual decision in which many variables need to be considered. The data discussed in this article can help in decision-making and emphasize the unique characteristics of the available therapeutic approaches, in particular regarding postoperative follow-up.
自从引入抗血管内皮生长因子（VEGF）治疗以来，早产儿视网膜病变（ROP）的治疗有了新的动态。本综述总结临床试验数据，以帮助做出明智的决策。
在本文中，对关键临床试验进行了总结，并讨论了其对ROP治疗的意义。
接受视网膜冷冻凝固术治疗ROP的儿童在CRYO-ROP研究中的随访期最长。基于ETROP研究及其他研究结果，视网膜激光治疗已取代冷冻疗法成为标准治疗方法。对于抗VEGF治疗，迄今为止有三项对照临床试验：BEAT-ROP、CARE-ROP和PEDIG研究。综合这些研究表明，抗VEGF在治疗急性ROP方面有效。然而，它们也强调了（晚期）复发的风险以及关于药物选择、剂量和长期安全性等基本未解决的问题。
ROP的治疗仍然是一个高度个体化的决策，需要考虑许多变量。本文讨论的数据有助于决策，并强调了现有治疗方法的独特特点，特别是关于术后随访方面。
