Clinical Vision Science Program, IWK Health Centre, Dalhousie University, Halifax, N.S.; Pediatric Ophthalmology, Helen DeVos Children's Hospital, Grand Rapids, MI.
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, Ont.; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont.
Can J Ophthalmol. 2021 Jun;56(3):179-183. doi: 10.1016/j.jcjo.2020.10.007. Epub 2020 Nov 5.
Retinopathy of prematurity (ROP) is a leading cause of childhood visual impairment. Treatment options for severe ROP include laser and/or anti-vascular endothelial growth factor (anti-VEGF) injections. Previous studies have compared the 2 treatments for functional outcomes including visual acuity, amblyopia, and strabismus. The purpose of this study was to evaluate the influence of treatment on binocularity.
In this masked, cross-sectional study, binocularity was measured using Bagolini lenses and the Frisby stereotest in children aged 3-8 years with a history of ROP treatment in 2 Canadian centres. Events associated with disruption of binocularity including amblyopia, anisometropia, and strabismus, were recorded and analyzed as secondary outcomes.
A total of 42 children were recruited: 19 were treated with laser and 23 with an anti-VEGF agent. The mean age at the time of assessment in the laser group was 81.2 (6.8 years) ± 16.2 months versus 63 (5.25 years) ± 15.7 months in the anti-VEGF group (p < 0.001). No statistically significant difference in rates of binocularity was detected (68% laser vs 82% anti-VEGF, p = 0.27). Laser-treated participants experienced a greater number of cumulative insults to binocularity (p = 0.01).
Patients with a history of ROP treated with laser or anti-VEGF agents require long-term follow-up to address binocularity-disrupting factors. Although we did not detect a difference in rates and level of binocularity between treatment groups, we did find an increased rate of cumulative binocularity disrupting events in the laser-treated group.
早产儿视网膜病变（ROP）是儿童视力损害的主要原因。严重 ROP 的治疗选择包括激光和/或抗血管内皮生长因子（anti-VEGF）注射。先前的研究比较了两种治疗方法在视力、弱视和斜视等功能结果方面的疗效。本研究旨在评估治疗对双眼视功能的影响。
在这项加拿大两个中心进行的、采用盲法、横断面研究中，使用巴格利尼滤光镜和弗里西立体测试评估了有 ROP 治疗史的 3-8 岁儿童的双眼视功能。记录并分析了与双眼视功能障碍相关的事件，包括弱视、屈光不正和斜视，并将其作为次要结局进行分析。
共招募了 42 名儿童：19 名接受激光治疗，23 名接受抗 VEGF 药物治疗。激光组评估时的平均年龄为 81.2（6.8 岁）±16.2 个月，而抗 VEGF 组为 63（5.25 岁）±15.7 个月（p＜0.001）。两组的双眼视功能率无统计学差异（激光组 68%，抗 VEGF 组 82%，p=0.27）。激光治疗组经历了更多的双眼视功能障碍累积打击（p=0.01）。
接受激光或抗 VEGF 药物治疗的 ROP 患者需要长期随访以解决双眼视功能障碍的因素。尽管我们未发现两组间治疗率和双眼视功能水平存在差异，但发现激光治疗组累积性双眼视功能障碍事件的发生率更高。
