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不同治疗管理对重度早产儿视网膜病变屈光结局的影响评估

Evaluation of the Effect of Different Treatment Management on Refractive Outcomes in Severe Retinopathy of Prematurity.

作者信息

Tiryaki Demir Semra, Keles Yesiltas Sumeyra, Karapapak Murat, Betul Akbas Ozyurek Emine, Bulbul Ali, Sinan Uslu Hasan, Guven Dilek

机构信息

Department of Ophthalmology, University of Health Sciences Turkey, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey.

Department of Ophthalmology, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

出版信息

Sisli Etfal Hastan Tip Bul. 2021 Dec 29;55(4):545-550. doi: 10.14744/SEMB.2021.34966. eCollection 2021.

Abstract

OBJECTIVES

The purpose of the study was to evaluate the effect of different treatment modalities on refractive outcomes in patients treated with severe retinopathy of prematurity (ROP).

METHODS

The records of children who were treated for severe ROP in our clinic between January 2015 and August 2018 were retrospectively reviewed. The children who were treated were analyzed in three subgroups as intravitreal bevacizumab (IVB), laser photocoagulation (LPC), and IVB + LPC. Spherical equivalent (SEQ), spherical and cylindrical power measurements of the cases were recorded in diopters (D). SE ≤-0.25D was accepted as myopia and SE of more than 1 D between two eyes was accepted as anisometropia.

RESULTS

A total of 160 eyes of 80 participants were eligible for inclusion: 38 eyes in the IVB group, 24 eyes in the LPC group, 16 eyes in the IVB + LPC group, 44 eyes in the spontaneously regressed group, and 38 eyes in the full-term children. Although the mean spherical power and SEQ in the IVB group were lower than in the LPC group (p=0.019 and 0.013, respectively), there was no significant difference between the IVB group and the IVB + LPC group (p=0.541 and 0.804, respectively). In terms of mean cylindrical power and prevalence of myopia and anisometropia, there was no significant difference between the treatment groups (p>0.05).

CONCLUSION

Although spherical power and SEQ can change according to the ROP treatment management, there is no difference in terms of the cylindrical power, prevalence of myopia, and anisometropia. The most important risk factor for myopia and anisometropia in premature children may be ROP severity and retinal immaturity.

摘要

目的

本研究旨在评估不同治疗方式对重度早产儿视网膜病变(ROP)患者屈光结果的影响。

方法

回顾性分析2015年1月至2018年8月在我院接受重度ROP治疗的儿童记录。将接受治疗的儿童分为玻璃体内注射贝伐单抗(IVB)、激光光凝(LPC)和IVB+LPC三个亚组。记录病例的等效球镜度(SEQ)、球镜度和柱镜度,单位为屈光度(D)。等效球镜度≤-0.25D被视为近视,双眼等效球镜度差值大于1D被视为屈光参差。

结果

共有80名参与者的160只眼符合纳入标准:IVB组38只眼,LPC组24只眼,IVB+LPC组16只眼,自发消退组44只眼,足月儿童组38只眼。虽然IVB组的平均球镜度和SEQ低于LPC组(分别为p=0.019和0.013),但IVB组与IVB+LPC组之间无显著差异(分别为p=0.541和0.804)。在平均柱镜度、近视患病率和屈光参差方面,各治疗组之间无显著差异(p>0.05)。

结论

虽然球镜度和SEQ会根据ROP治疗方案而变化,但在柱镜度、近视患病率和屈光参差方面并无差异。早产儿近视和屈光参差的最重要危险因素可能是ROP严重程度和视网膜不成熟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2aa8/8907699/2f6b15d951df/SEMB-55-545-g001.jpg

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