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早产儿视网膜病变激光光凝与玻璃体腔内注射bevacizumab 治疗 5 年的安全性和疗效比较。

Comparison of 5-year safety and efficacy of laser photocoagulation and intravitreal bevacizumab injection in retinopathy of prematurity.

机构信息

Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.

Department of Child Health, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2021 Sep;259(9):2849-2855. doi: 10.1007/s00417-021-05137-9. Epub 2021 Mar 21.

Abstract

PURPOSE

To compare laser photocoagulation and intravitreal injection of bevacizumab (IVB) treatment for retinopathy of prematurity (ROP).

METHODS

The study included 52 eyes of 26 patients after ROP treatment who were observed up to 5 years of age. Twenty-eight eyes received laser photocoagulation as the initial treatment (laser group), and twenty-four eyes underwent IVB (IVB group). We collected data on gestational age, birth weight, 1- and 5-min Apgar scores, zone and stage at the time of treatment, recurrence of ROP and best-corrected visual acuity (BCVA) (logMAR), equivalent spherical value (SE), ocular complications, and developmental delay at the age of 5.

RESULTS

More zone I low-stage eyes were treated with IVB than laser. There was no difference in BCVA (p = 0.836). Although the mean SE was not different between the groups (p = 0.280), the prevalence of myopia was significantly higher in the laser group (p = 0.020). Developmental delay was observed in 3 of 14 and 3 of 12 cases in the laser and IVB groups, respectively (p = 0.596). Retinal holes were observed in 2 eyes in the IVB group, with 1 developing localized retinal detachment. There were no significant differences between the groups in the other factors.

CONCLUSIONS

Compared to laser for ROP, IVB was not inferior in neurodevelopment or visual outcome and was superior in refractive error. As cases in the IVB group showed retinal holes, long-term follow-up with fundus examination is recommended after IVB.

摘要

目的

比较激光光凝和玻璃体内注射贝伐单抗(IVB)治疗早产儿视网膜病变(ROP)的效果。

方法

本研究纳入了 26 例 ROP 治疗后患者的 52 只眼,随访至 5 岁。28 只眼接受激光光凝作为初始治疗(激光组),24 只眼接受 IVB(IVB 组)。我们收集了治疗时的胎龄、出生体重、1 分钟和 5 分钟 Apgar 评分、治疗时所处的区和期、ROP 复发和最佳矫正视力(BCVA)(logMAR)、等效球镜值(SE)、眼部并发症和 5 岁时的发育迟缓的数据。

结果

IVB 治疗的区 I 低期眼多于激光。BCVA 无差异(p = 0.836)。尽管两组间平均 SE 无差异(p = 0.280),但激光组的近视患病率显著更高(p = 0.020)。激光组和 IVB 组各有 3 例(分别为 3/14 和 3/12)出现发育迟缓(p = 0.596)。IVB 组有 2 只眼出现视网膜裂孔,其中 1 只眼出现局限性视网膜脱离。其他因素两组间无显著差异。

结论

与激光治疗 ROP 相比,IVB 在神经发育或视力结果方面不劣,在屈光不正方面更优。由于 IVB 组的病例出现了视网膜裂孔,建议在 IVB 后进行长期的眼底检查随访。

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