Department of ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of ophthalmology, Tianjin Medical University Eye Hospital & Tianjin Medical University Eye Institute, Tianjin, China.
Graefes Arch Clin Exp Ophthalmol. 2020 May;258(5):1005-1012. doi: 10.1007/s00417-020-04600-3. Epub 2020 Feb 11.
To describe the surgical procedures, outcomes, and complications of a novel technique of subretinal injection of ranibizumab (SRR).
Between September 2012 and September 2018, 37 eyes of 26 consecutive children with vascularly active total retinal detachments in 1 or both eyes treated with SRR as primary treatment were included in this retrospective study. All included eyes received subretinal injection of ranibizumab (0.25 mg/ 0.025 ml). Data included demographics, ocular examination, and anatomic outcomes, following treatment and complications of eyes after SRR were collected.
Eleven patients had bilateral SRR injections and 15 had monocular SRR injection. Thirteen patients were diagnosed as retinopathy of prematurity. Of all patients, the mean gestational age was 34.5 ± 5.1 weeks (range: 29.640.7 weeks), and birth weight was 2328.1 ± 1083.9 g (range: 9403900 g). On 1-week postoperative follow-up, vascular activity decreased in all 37 eyes (100%). On the 1-month postoperative follow-up, vascular activity decreased but remained in 24 eyes (24/35, 68.6%) of 16 patients and vanished in 11 eyes (11/35, 31.4%) of 9 patients. No eye needed a secondary anti-VEGF therapy. Local subconjunctival hemorrhage was noted in two eyes (2/37, 5.4%). Localized wound leakage of subretinal fluid was also noted in one eye (1/37, 2.7%).
In this very limited study, we showed that SRR in vascularly active advanced pediatric vasoproliferative disorders with total retinal detachments is effective and promising, although more extensive controlled trials will be needed to confirm its safety and efficacy.
描述一种新型视网膜下注射雷珠单抗（SRR）手术的操作步骤、结果和并发症。
本回顾性研究纳入了 2012 年 9 月至 2018 年 9 月期间，37 只眼 26 例连续性患儿的临床资料，这些患儿均患有单眼或双眼血管活跃性全视网膜脱离，且接受了 SRR 作为初始治疗。所有纳入的眼均接受了雷珠单抗（0.25mg/0.025ml）的视网膜下注射。收集了治疗后的眼部人口统计学资料、眼部检查和解剖学结果，以及 SRR 后的并发症。
11 例患者进行了双眼 SRR 注射，15 例患者进行了单眼 SRR 注射。13 例患者被诊断为早产儿视网膜病变。所有患者的平均胎龄为 34.5±5.1 周（范围：29.640.7 周），出生体重为 2328.1±1083.9g（范围：9403900g）。术后 1 周随访时，37 只眼中所有眼的血管活性均降低（100%）。术后 1 个月随访时，16 例患者中有 24 只眼（24/35，68.6%）的血管活性降低但仍存在，9 例患者中有 11 只眼（11/35，31.4%）的血管活性消失。无眼需要二次抗 VEGF 治疗。2 只眼（2/37，5.4%）出现局部结膜下出血。1 只眼（1/37，2.7%）出现局部视网膜下液渗漏。
在这项非常有限的研究中，我们表明 SRR 治疗伴有全视网膜脱离的儿童血管活跃性晚期血管增殖性疾病是有效且有前途的，尽管需要进行更广泛的对照试验来证实其安全性和疗效。
