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早产儿视网膜病变抗血管内皮生长因子治疗的安全性更新。

Update on Anti-Vascular Endothelial Growth Factor Safety for Retinopathy of Prematurity.

机构信息

Department of Ophthalmology, New England Eye Center, Tufts University School of Medicine, Boston, MA.

California Retina Consultants, Santa Barbara, CA.

出版信息

Asia Pac J Ophthalmol (Phila). 2020 Jul-Aug;9(4):358-368. doi: 10.1097/APO.0000000000000302.

Abstract

Retinopathy of prematurity (ROP) is a neovascular retinal disorder that occurs in infants born prematurely. Nowadays, ROP constitutes a leading cause of childhood blindness worldwide and for decades the standard of care has involved peripheral retinal ablation. However, this type of treatment requires the use of specialized equipment by well-trained physicians, has been associated with poor structural and visual outcomes in some preterm infants, and despite its adequate application, some cases of ROP may continue to progress. Therefore, the need for simpler and more efficient strategies made anti-vascular endothelial growth factor (anti-VEGF) medications an appealing option for treatment. Recently, the use of anti-VEGF agents for ROP has increased worldwide; nevertheless, this practice remains off-label, and there is a lack of information regarding its safety profile and the possibility of unfavorable long-term outcomes causes the utmost concern. This review updates the recent evidence regarding the systemic and ocular safety of anti-VEGF treatment for ROP.

摘要

早产儿视网膜病变(ROP)是一种发生于早产儿的新生血管性视网膜疾病。如今,ROP 已成为全球儿童失明的主要原因,几十年来,该疾病的标准治疗方法是进行周边视网膜光凝。然而,这种治疗方法需要由经过专业培训的医生使用专门设备,而且在一些早产儿中与较差的结构和视觉结果相关,并且尽管已经进行了适当的应用,但ROP 的一些病例可能仍会继续进展。因此,需要更简单、更有效的策略,这使得抗血管内皮生长因子(anti-VEGF)药物成为一种有吸引力的治疗选择。最近,抗 VEGF 药物在全球范围内被越来越多地用于 ROP 的治疗;然而,这种做法仍然是超适应证的,并且缺乏关于其安全性概况和可能产生不良长期结果的信息,这引起了极大的关注。本综述更新了关于 ROP 抗 VEGF 治疗的全身和眼部安全性的最新证据。

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