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渗出性视网膜脱离作为早产儿视网膜病变的初始表现:一种罕见表现的临床特征和结局。

Exudative retinal detachment as an initial presentation of retinopathy of prematurity: Clinical profile and outcomes of a rare presentation.

机构信息

Smt Kanuri Santhamma Center for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India.

Smt Kanuri Santhamma Center for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India; Department of Ophthalmology, Jigme Dorji Wangchuk National Referral Hospital, Thimpu, Bhutan.

出版信息

Indian J Ophthalmol. 2022 Jul;70(7):2486-2489. doi: 10.4103/ijo.IJO_407_22.

Abstract

PURPOSE

To describe the clinical profile and treatment outcomes of infants with retinopathy of prematurity (ROP) presenting with isolated exudative retinal detachment (ERD).

METHODS

Retrospective interventional case series. Preterm infants diagnosed with ROP with ERD at presentation were included. All demographic details, clinical findings, and treatment given were documented. The anatomical outcome was categorized as good, fair, and poor. Refractive outcome was classified into mild, moderate, and severe according to spherical equivalent at the last visit.

RESULTS

Fifteen eyes (8 patients) were included. Mean gestational age was 31.3 weeks, and birth weight was 1462.6 g. All eyes presented with aggressive ROP. Patches of retinal edema in avascular retina were seen in all eyes. A total of 86.6% of eyes had vascular sclerosis while 86.6% of eyes had subretinal exudates. The anatomical outcome was good in all eyes. In addition, 40% of eyes had a mild refractive error.

CONCLUSION

Exudative retinal detachment in ROP is rare. The use of unregulated oxygen can be a contributory factor. Vascular sclerosis is consistent with hyperoxia-induced retinopathy models. Retinal edema and subretinal exudates indicate disrupted inner and outer blood-retinal barrier. Treatment outcomes are good when diagnosed and treated in time.

摘要

目的

描述以孤立性渗出性视网膜脱离(ERD)为表现的早产儿视网膜病变(ROP)婴儿的临床特征和治疗结果。

方法

回顾性干预性病例系列研究。纳入在就诊时被诊断为 ROP 并伴有 ERD 的早产儿。记录所有人口统计学细节、临床发现和治疗方法。解剖学结果分为良好、一般和差。根据最后一次就诊时的等效球镜度数将屈光结果分为轻度、中度和重度。

结果

纳入了 15 只眼(8 位患者)。平均胎龄为 31.3 周,出生体重为 1462.6g。所有眼睛均表现为侵袭性 ROP。所有眼睛的无血管视网膜上均可见视网膜水肿斑。共有 86.6%的眼睛出现血管硬化,86.6%的眼睛出现视网膜下渗出。所有眼睛的解剖学结果均良好。此外,40%的眼睛有轻度屈光不正。

结论

ROP 中的渗出性视网膜脱离较为罕见。使用未经监管的氧气可能是一个促成因素。血管硬化与高氧诱导的视网膜病变模型一致。视网膜水肿和视网膜下渗出表明内、外血视网膜屏障受损。如果及时诊断和治疗,治疗结果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05dd/9426080/e76a915a8352/IJO-70-2486-g001.jpg

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