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早产儿视网膜病变非手术治疗后闭角型青光眼伴小角膜及晶状体增厚

Microcornea and Thickened Lens in Angle Closure following Nonsurgical Treatment of Retinopathy of Prematurity.

作者信息

Chang Ta C, Tran Kimberly D, Cernichiaro-Espinosa Linda A, Leung Ella H, Grajewski Alana L, Hodapp Elizabeth A, Abou Shousha Mohamed F, Berrocal Audina M

机构信息

Bascom Palmer Eye Institute, Miami, FL, USA.

Asociación para Evitar la Ceguera en México, Mexico City, Mexico.

出版信息

J Ophthalmol. 2020 May 6;2020:7510903. doi: 10.1155/2020/7510903. eCollection 2020.

Abstract

PURPOSE

To characterize the clinical features in young patients with angle closure and to determine the characteristics associated with acquired anterior segment abnormality following retinopathy of prematurity (ROP) treatment.

METHODS

We performed two retrospective case-control series. In the first series, we identified consecutive young angle closure patients without prior surgeries, with and without a history of ROP treatment; in the second series we identified consecutive patients who underwent ROP treatment, without and without anterior segment changes.

RESULTS

In the first series, 25 eyes of 14 consecutive angle closure patients were included: 19 eyes (11 patients, 78.6%) had a history of treated ROP, while 6 eyes (3 patients) belonged to full-term patients. The treated ROP eyes had significantly shallower anterior chambers (1.77 ± 0.17 mm vs 2.72 ± 0.18 mm, < 0.0001) and thicker lenses (5.20 ± 0.54 mm vs 3.98 ± 0.20 mm, = 0.0002) compared to the full-term controls. In the second series, 79 eyes of 40 patients were included, with median gestational age of 24.6 weeks. Acquired iridocorneal adhesion was noted in the eight eyes (10.1%) at a mean age of 4.7 years and was associated with prior zone 1 and plus disease ( = 0.0013), a history of initial intravitreal bevacizumab treatment (IVB, = 0.0477) and a history of requiring additional IVB after initial treatment ( = 0.0337).

CONCLUSIONS

Many young angle closure patients may have a history of treated ROP and may present with the triad of increased lens thickness, microcornea, and angle closure.

摘要

目的

描述年轻闭角型青光眼患者的临床特征,并确定与早产儿视网膜病变(ROP)治疗后获得性眼前段异常相关的特征。

方法

我们进行了两个回顾性病例对照系列研究。在第一个系列中,我们纳入了连续的未接受过手术的年轻闭角型青光眼患者,有或无ROP治疗史;在第二个系列中,我们纳入了连续的接受过ROP治疗的患者,有或无前房改变。

结果

在第一个系列中,纳入了14例连续闭角型青光眼患者的25只眼:19只眼(11例患者,78.6%)有ROP治疗史,而6只眼(3例患者)为足月出生患者。与足月对照组相比,接受过ROP治疗的眼睛前房明显更浅(1.77±0.17mm对2.72±0.18mm,P<0.0001),晶状体更厚(5.20±0.54mm对3.98±0.20mm,P = 0.0002)。在第二个系列中,纳入了40例患者的79只眼,中位胎龄为24.6周。8只眼(10.1%)在平均4.7岁时出现获得性虹膜角膜粘连,与先前的1区病变和增值性病变(P = 0.0013)、初始玻璃体腔内注射贝伐单抗治疗(IVB,P = 0.0477)以及初始治疗后需要额外IVB的病史(P = 0.0337)相关。

结论

许多年轻闭角型青光眼患者可能有ROP治疗史,并可能表现为晶状体厚度增加、小角膜和闭角三联征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d8/7225864/1c6a3cb75675/JOPH2020-7510903.001.jpg

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