Zou Qiong, Zhu Yan-Qiong, Zhang Feng-Jun, Liu Qiu-Ping
Affiliated Eye Hospital of Nanchang University, Nanchang 330000, Jiangxi Province, China.
Int J Ophthalmol. 2022 May 18;15(5):753-759. doi: 10.18240/ijo.2022.05.10. eCollection 2022.
To evaluate efficacy of intravitreal ranibizumab (IVR) therapy for aggressive posterior retinopathy of prematurity (ROP), threshold ROP disease and type 1 pre-threshold ROP.
A retrospective analysis was performed on 40 patients (76 eyes) who had IVR as the primary treatment for ROP from April 2017 to January 2018. According to disease pathogenic features, the 76 eyes were divided into three groups: aggressive posterior ROP (AP-ROP) group (16 eyes), threshold ROP group (28 eyes) and type 1 pre-threshold ROP group (32 eyes). The characteristics of patients and lesions situation before the first intravitreal injection, and posttreatment fundus outcomes determined by wide-angle RetCam fundus imaging were recorded.
The birth weight and postmenstrual age of first IVR treatment in AP-ROP, threshold ROP, and type 1 pre-threshold ROP groups were significant difference (1087.50±246.78, 1103.75±168.30, 1257.03±210.82 g, =0.005; 34.50±1.46, 36.89±2.97, 36.50±2.36wk, =0.008), while the gestational age was not difference (28.00±2.00, 28.54±1.90, 28.59±1.43wk, =0.510). The retina hemorrhage ratio (with/without: 14/2, 8/20, 5/27), iris neovascularization or vascular engorgement ratio (with/without: 12/4, 11/17, 6/26), and the zone I (inside/outside: 16/0, 2/26, 5/27) in AP-ROP, threshold ROP, and type 1 pre-threshold ROP group were difference significantly (all <0.05). The regression rates were 37.5%, 92.86%, and 100%, and the recurrence rates were 62.5%, 7.14%, and 0 in AP-ROP, threshold ROP, and type 1 pre-threshold ROP group, respectively (both <0.05). The recurrence eyes were cured by secondary IVR or retinal laser photocoagulation.
IVR is an effective treatment for all types of ROP. The regression of AP-ROP is significantly lower than type 1 pre-threshold and threshold disease. Birth weight, retinal hemorrhage, iris neovascularization or vascular engorgement and lesions located in zone I may be associated with AP-ROP recurrence and retreatment, which should be noted in follow-up.
评估玻璃体内注射雷珠单抗（IVR）治疗侵袭性后部早产儿视网膜病变（ROP）、阈值ROP疾病和1型阈值前ROP的疗效。
对2017年4月至2018年1月期间接受IVR作为ROP主要治疗方法的40例患者（76只眼）进行回顾性分析。根据疾病致病特征，将76只眼分为三组：侵袭性后部ROP（AP-ROP）组（16只眼）、阈值ROP组（28只眼）和1型阈值前ROP组（32只眼）。记录首次玻璃体内注射前患者的特征和病变情况，以及通过广角RetCam眼底成像确定的治疗后眼底结果。
AP-ROP组、阈值ROP组和1型阈值前ROP组首次IVR治疗时的出生体重和孕龄存在显著差异（分别为1087.50±246.78、1103.75±168.30、1257.03±210.82 g，P = 0.005；34.50±1.46、36.89±2.97、36.50±2.36周，P = 0.008），而胎龄无差异（分别为28.00±2.00、28.54±1.90、28.59±1.43周，P = 0.510）。AP-ROP组、阈值ROP组和1型阈值前ROP组的视网膜出血比例（有/无：14/2、8/20、5/27）、虹膜新生血管或血管充血比例（有/无：12/4、11/17、6/26）以及I区病变情况（内/外：16/0、2/26、5/27）差异均有统计学意义（均P<0.05）。AP-ROP组、阈值ROP组和1型阈值前ROP组的消退率分别为37.5%、92.86%和100%，复发率分别为62.5%、7.14%和0（均P<0.05）。复发眼通过二次IVR或视网膜激光光凝治愈。
IVR是治疗所有类型ROP的有效方法。AP-ROP的消退率明显低于1型阈值前和阈值疾病。出生体重、视网膜出血、虹膜新生血管或血管充血以及位于I区的病变可能与AP-ROP的复发和再次治疗有关，随访时应予以注意。
