Cilsal Erman, Sukgen Emine Alyamac
Mehmet Akif Ersoy, Gogus Kalp Damar Cerrahisi, Egitim Arastirma Hastanesi, Istanbul, Turkey. Email:
Department of Ophthalmology, Adana City Education and Research Hospital, Adana, Turkey.
Cardiovasc J Afr. 2020;31(3):123-129. doi: 10.5830/CVJA-2019-058. Epub 2020 Jan 13.
The aim of this study was to compare the cardiac effects and aortic arterial indices following intravitreal aflibercept treatment or diode laser photocoagulation for the treatment of retinopathy of prematurity (ROP) in infants.
This single-centre, retrospective study was conducted in infants who were administered laser photocoagulation (LPC) or intravitreal aflibercept (IVA) treatment as initial treatment and had completed at least one year of corrected age. The patients were evaluated in terms of aortic elastic parameters, right and left ventricular systolic and diastolic function using conventional, pulsed Doppler and tissue Doppler imaging (TDI) echocardiographic parameters.
Fifteen infants were in the LPC group, 16 in the IVA group, and 20 in the control group. Although there were some statistically significant differences in terms of pulsed and TDI echocardiographic parameters between the treatment and control groups, these values could not clearly be adopted as a diastolic dysfunction and myocardial performance indices were not influenced. The aortic elastic parameters were impaired in both LPC and IVA groups compared to the control group. Consequently, we observed only minor differences between the treatment groups, which may suggest subtle changes due to the anti-angiogenic treatment.
Although favourable and promising outcomes were obtained with intravitreal injection of anti-vascular endothelial growth factor agents for the treatment of ROP, concerns have been raised about potential systemic side effects, including potential cardiovascular side effects caused by these agents. The small reduction in right ventricular Doppler velocities could probably be explained by the use of anti-angiogenic or laser treatment in infants.
本研究旨在比较玻璃体内注射阿柏西普或二极管激光光凝治疗婴儿早产儿视网膜病变（ROP）后的心脏效应和主动脉动脉指数。
本单中心回顾性研究纳入了接受激光光凝（LPC）或玻璃体内注射阿柏西普（IVA）作为初始治疗且矫正年龄至少满1年的婴儿。使用传统、脉冲多普勒和组织多普勒成像（TDI）超声心动图参数对患者的主动脉弹性参数、左右心室收缩和舒张功能进行评估。
LPC组有15名婴儿，IVA组有16名，对照组有20名。虽然治疗组和对照组在脉冲和TDI超声心动图参数方面存在一些统计学上的显著差异，但这些值不能明确作为舒张功能障碍的指标，心肌性能指标也未受影响。与对照组相比，LPC组和IVA组的主动脉弹性参数均受损。因此，我们在治疗组之间仅观察到微小差异，这可能表明抗血管生成治疗导致了细微变化。
虽然玻璃体内注射抗血管内皮生长因子药物治疗ROP取得了良好且有前景的结果，但人们对其潜在的全身副作用，包括这些药物引起的潜在心血管副作用表示担忧。右心室多普勒速度的小幅降低可能可以用婴儿使用抗血管生成或激光治疗来解释。
