Ekinci Dilbade Yıldız, Vural Asli Deger, Bayramoglu Sadik Etka, Onur Ismail Umut, Hergunsel Gulsum Oya
Gazi Yaşargil Eğitim ve Araştırma Hastanesi, Diyarbakir, Turkey.
Int Ophthalmol. 2019 Dec;39(12):2697-2705. doi: 10.1007/s10792-019-01088-7. Epub 2019 Mar 4.
Evaluation of vascular leakage and retinal vascular development with fundus fluorescein angiography for infants diagnosed with aggressive posterior retinopathy of prematurity who underwent intravitreal anti-VEGF treatment.
Medical recordings of 30 patients who received RetCam fluorescein angiography during follow-up and had been treated with anti-VEGF on diagnosis of aggressive posterior ROP in the zone I or zone II between the dates of April 2014-January 2017 were evaluated retrospectively.
Fifty-nine eyes of 30 patients were included in the study. Mean birth weight was 1145 g; gestation week was 28.4. Recurrence occurred in 30.5% of the patients, and 10.1% of them were given a second dose of injection of anti-VEGF. Leakage was detected in 15.3% of the eyes during angiography, and all of these eyes were treated with laser photocoagulation. Evaluation of vascular development revealed that in the temporal, complete retinal vascular development was achieved in only 8% of the eyes. It was detected that complete retinal vascularization was not observed in any of the cases which were given second dose of injection due to recurrence. The patients were distributed into groups according to postmenstrual week taken to angiography as 32 eyes of 16 patients in group 1, 17 eyes of 9 patients in group 2 and 10 eyes of 5 patients in group 3. The vascular leakage rate of group 3 patients was statistically significantly higher (p < 0.05) and vascular development between groups was not statistically significant (p > 0.05).
With the initiation of FFA usage in pediatric cases, especially treated with anti-VEGF due to retinopathy of prematurity (ROP), more findings (vascular arrest, leakage, and abnormalities, etc.) are obtained than those achieved via ophthalmoscopic examination. In the light of these findings, early intervention with laser photocoagulation in early stages becomes possible enabling prevention of possible blindness.
通过眼底荧光血管造影评估接受玻璃体内抗血管内皮生长因子（VEGF）治疗的侵袭性早产儿视网膜病变婴儿的血管渗漏和视网膜血管发育情况。
回顾性评估2014年4月至2017年1月期间30例在随访期间接受RetCam荧光血管造影且在诊断为I区或II区侵袭性后极部视网膜病变（ROP）时接受抗VEGF治疗的患者的医疗记录。
30例患者的59只眼纳入研究。平均出生体重为1145克；孕周为28.4周。30.5%的患者出现复发，其中10.1%接受了第二剂抗VEGF注射。血管造影期间15.3%的眼睛检测到渗漏，所有这些眼睛均接受了激光光凝治疗。血管发育评估显示，在颞侧，仅8%的眼睛实现了完全视网膜血管发育。发现因复发接受第二剂注射的病例中，无一例观察到完全视网膜血管化。根据血管造影时的月经周数将患者分组，第1组16例患者的32只眼，第2组9例患者的17只眼，第3组5例患者的10只眼。第3组患者的血管渗漏率在统计学上显著更高（p < 0.05），组间血管发育无统计学意义（p > 0.05）。
随着眼底荧光血管造影（FFA）在儿科病例中的应用，尤其是因早产儿视网膜病变（ROP）接受抗VEGF治疗的病例，比通过检眼镜检查获得了更多的发现（血管停滞、渗漏和异常等）。根据这些发现，早期进行激光光凝干预成为可能，从而能够预防可能的失明。
