Emory University School of Medicine, Atlanta, Georgia.
Emory University School of Medicine, Atlanta, Georgia; The Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia.
Ophthalmol Retina. 2020 Jul;4(7):720-727. doi: 10.1016/j.oret.2020.02.001. Epub 2020 Feb 11.
To review the clinical features, treatment outcomes, and prevalence within our clinic population of adolescents and adults with previously regressed retinopathy of prematurity (ROP) who demonstrate late-onset exudation and vasoproliferative changes.
Retrospective review of consecutive patients at a single center.
Five patients (5 eyes) with a history of ROP who showed new exudates or worsening fibrovascular proliferation diagnosed after 10 years of age.
Patients were identified by a computerized search of the Emory Eye Center billing records. Data extracted from charts included baseline ROP information, visual acuity and other examination findings, imaging, and treatments.
Status of exudation and vasoproliferation.
Among 138 patients older than 10 years with ROP seen at our tertiary referral center from 2000 through 2018, 5 (3.6%) demonstrated late-onset exudation or vasoproliferation. Three patients were female and 3 underwent ROP treatment as neonates. Mean age at onset of late reactivation was 25.6 years (range, 13-43 years). Previous treatments for neonatal ROP included peripheral laser ablation (n = 3), scleral buckle (n = 2), pars plicata vitrectomy (n = 2), and no treatment (n = 2). Management strategies for late reactivation included observation (n = 1), intravitreal anti-vascular endothelial growth factor agents (n = 4), vitrectomy (n = 2), and cryotherapy (n = 1). With mean follow-up of 4.8 years (range, 1-7 years), outcomes were resolution of exudation or proliferation with return to baseline vision (n = 2), stable mild exudation (n = 1), and progressive vasoproliferation with traction leading to phthisis (n = 2).
Late-onset exudation and fibrovascular proliferation in adolescents and adults with ROP can occur rarely with previously regressed ROP. Two of 5 patients were refractory to all treatments and demonstrated phthisis bulbi. One patient showed reactivation in the form of a reactive retinal astrocytic tumor. Our findings highlight the importance continued monitoring with regular fundus examination in adolescents and adults with regressed ROP.
回顾我们诊所中先前退行性早产儿视网膜病变（ROP）患者的临床特征、治疗结果和患病率，这些患者在 10 岁后出现迟发性渗出和血管增生性改变。
单中心回顾性连续患者研究。
5 名（5 只眼）患者患有 ROP 病史，在 10 岁后诊断出有新的渗出物或进行性纤维血管增生。
通过 Emory 眼科中心计费记录的计算机搜索确定患者。从图表中提取的数据包括基线 ROP 信息、视力和其他检查结果、影像学和治疗。
渗出和血管增生的状态。
在我们的三级转诊中心 2000 年至 2018 年期间，有 138 名年龄大于 10 岁的 ROP 患者，其中 5 名（3.6%）出现迟发性渗出或血管增生。3 名患者为女性，3 名患者在新生儿期接受 ROP 治疗。迟发性再激活的平均发病年龄为 25.6 岁（范围 13-43 岁）。新生儿 ROP 的先前治疗包括周边激光消融（n=3）、巩膜扣带术（n=2）、睫状体扁平部玻璃体切除术（n=2）和无治疗（n=2）。迟发性再激活的治疗策略包括观察（n=1）、眼内抗血管内皮生长因子药物（n=4）、玻璃体切除术（n=2）和冷冻治疗（n=1）。平均随访 4.8 年（范围 1-7 年），结果为渗出或增生消退并恢复基线视力（n=2）、稳定的轻度渗出（n=1）和进行性血管增生伴牵引导致眼球萎缩（n=2）。
患有 ROP 的青少年和成年人中罕见出现先前退行性 ROP 的迟发性渗出和纤维血管增生。5 名患者中有 2 名对所有治疗均无效，表现为眼球萎缩。1 名患者出现反应性视网膜星形细胞瘤样再激活。我们的发现强调了对退行性 ROP 患者继续监测和定期眼底检查的重要性。
