Matsumoto Tadashi, Itokawa Takashi, Shiba Tomoaki, Tomita Masahiko, Hine Kotaro, Mizukaki Norio, Yoda Hitoshi, Hori Yuichi
Department of Ophthalmology, School of Medicine, Toho University, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan.
Department of Neonatology, School of Medicine, Toho University, Tokyo, Japan.
Graefes Arch Clin Exp Ophthalmol. 2018 Nov;256(11):2241-2247. doi: 10.1007/s00417-018-4063-0. Epub 2018 Jul 6.
To evaluate the relationship between ocular blood flow, expressed as mean blur rate (MBR) by laser speckle flowgraphy, and intravitreal bevacizumab (IVB) therapy in neonates with retinopathy of prematurity (ROP).
This was a case series study of 4 neonates with ROP under sedation before and after IVB and evaluated 8 eyes, in which the circulation could be measured three times consecutively. We performed optic nerve head blood flow measurement and fluorescein angiography (FA) before and 1 week after treatment. Blood flow was analyzed separately for MBR-A (mean of all values), MBR-V (vessel mean), and MBR-T (tissue mean). Comparisons between the MBR (-A, -V, -T), body weight, and other systemic and ocular parameters before and after treatment were performed using a paired t test.
The MBR values after IVB were lower than the pre-treatment values in all cases. All eyes showed leakage at neovascularization on FA before treatment. Although leakage improved 1 week after treatment, the neovascularization did not completely regress.
IVB improves vein dilation and artery tortuosity, while reducing ocular blood flow in neonates with ROP. We suggest that neovascularization might not be involved in reducing ocular blood flow in the early stage of IVB treatment.
通过激光散斑血流图以平均模糊率（MBR）表示评估眼部血流与玻璃体内注射贝伐单抗（IVB）治疗早产儿视网膜病变（ROP）之间的关系。
这是一项对4例ROP新生儿在IVB治疗前后镇静状态下进行的病例系列研究，评估了8只眼睛，其中血流可连续测量3次。我们在治疗前和治疗后1周进行了视神经乳头血流测量和荧光素血管造影（FA）。分别对MBR-A（所有值的平均值）、MBR-V（血管平均值）和MBR-T（组织平均值）进行血流分析。使用配对t检验对治疗前后的MBR（-A、-V、-T）、体重以及其他全身和眼部参数进行比较。
所有病例中IVB治疗后的MBR值均低于治疗前的值。所有眼睛在治疗前FA检查时新生血管处均显示渗漏。尽管治疗1周后渗漏有所改善，但新生血管并未完全消退。
IVB可改善ROP新生儿的静脉扩张和动脉迂曲，同时降低眼部血流。我们认为在IVB治疗早期，新生血管可能与眼部血流减少无关。
