Mammo Danny A, Rubino Shaina M, Quiram Polly A
Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota; and.
Vitreoretinal Surgery, PA, Edina, Minnesota.
Retina. 2021 Apr 1;41(4):706-710. doi: 10.1097/IAE.0000000000002943.
To assess the safety and efficacy of less dense panretinal photocoagulation after intravitreal bevacizumab in aggressive posterior retinopathy of prematurity infants.
Retrospective consecutive case series of premature infants diagnosed with aggressive posterior retinopathy of prematurity between August 2012 and November 2015 who received intravitreal bevacizumab with subsequent modified indirect diode laser panretinal photocoagulation for reactivation or incomplete vascularization. Main outcome measures included postprocedural reactivation, retinal detachments, or anterior segment ischemia.
Sixty-one eyes of 31 premature infants were identified. The average gestational age was 24 ± 2.2 weeks (range 22-27), and the average birth weight was 661.5 ± 167.1 g (range 340.0-930.5 g). The average follow-up was 3.9 ± 1.3 years (range 1.3-5.4 years). At the last follow-up, no patient had experienced postlaser reactivation, retinal detachments, anterior segment ischemia, or other laser complications.
This study suggests that nonconfluent panretinal photocoagulation for aggressive posterior retinopathy of prematurity infants who have received intravitreal bevacizumab may be safe and effective. This study's strengths include a sizeable sample size, long-term follow-up of nearly 4 years, and consistency in treatment among patients by a single, experienced retinopathy of prematurity specialist.
评估玻璃体内注射贝伐单抗后，对侵袭性早产儿视网膜病变患儿进行低密度全视网膜光凝的安全性和有效性。
回顾性连续病例系列研究，纳入2012年8月至2015年11月期间诊断为侵袭性早产儿视网膜病变的早产儿，这些患儿接受了玻璃体内注射贝伐单抗，随后采用改良间接二极管激光进行全视网膜光凝，以治疗病变复发或血管化不完全。主要观察指标包括术后病变复发、视网膜脱离或眼前节缺血。
共纳入31例早产儿的61只眼。平均胎龄为24±2.2周（范围22 - 27周），平均出生体重为661.5±167.1 g（范围340.0 - 930.5 g）。平均随访时间为3.9±1.3年（范围1.3 - 5.4年）。在最后一次随访时，没有患者出现激光治疗后病变复发、视网膜脱离、眼前节缺血或其他激光相关并发症。
本研究表明，对于接受玻璃体内注射贝伐单抗的侵袭性早产儿视网膜病变患儿，采用非融合性全视网膜光凝可能是安全有效的。本研究的优势包括样本量较大、近4年的长期随访，以及由单一经验丰富的早产儿视网膜病变专家对患者进行一致的治疗。
