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抗血管内皮生长因子单药治疗早产儿视网膜病变对眼视网膜和屈光发育的长期影响。

LONG-TERM EFFECTS OF ANTI-VEGF MONOTHERAPY FOR RETINOPATHY OF PREMATURITY ON THE RETINAL AND REFRACTIVE DEVELOPMENT OF EYE.

机构信息

Department of Ophthalmology, Gazi University Faculty of Medicine, Ankara, Turkey; and.

Department of Ophthalmology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey.

出版信息

Retina. 2022 Nov 1;42(11):2194-2202. doi: 10.1097/IAE.0000000000003590.

Abstract

PURPOSE

To evaluate vascular maturation of retina, axial, refractive, and foveal development after anti-VEGF treatment including bevacizumab, ranibizumab, and aflibercept in infants with treatment requiring retinopathy of prematurity (ROP) in long term.

METHODS

This retrospective chart review study included children with a history of any anti-VEGF monotherapy for ROP in Zone 1 or posterior Zone 2 who have reached at least 24 months of corrected age. The records of ophthalmologic examination including strabismus evaluation, visual acuity measurement, refractive and axial measurements, optical coherence tomography, and fundus fluorescein angiography examinations with RetCam III were reviewed.

RESULTS

A total of 36 eyes of 18 children met the inclusion criteria. The mean gestational age at birth was 27.8 2.13 (23-30) weeks, and ocular assessments were performed between 33 and 61.5 (mean: 42.58 8.6) months of corrected age. Treatment was with bevacizumab in 10 eyes, with ranibizumab in 14 eyes, and with aflibercept in 12 eyes. The mean spherical equivalent was -0.25 1.82; axial length was 20.81 0.62 mm. There was no significant difference among three anti-VEGF groups regarding the abnormal vascular retinal development ( P = 0.183) or leakage ( P = 0.842) on fluorescein angiography.

CONCLUSION

All the anti-VEGF agents provided similar adequate axial and refractive development as well as similar abnormal vascular development in the peripheral retina. The long-term impact of this abnormally vascularized peripheral retina is a curiosity issue. From this point of view, it is an important need to determine the follow-up period and method after the anti-VEGF treatment for ROP.

摘要

目的

评估抗血管内皮生长因子(VEGF)治疗后视网膜血管成熟度、眼轴、屈光和中心凹发育情况,包括贝伐单抗、雷珠单抗和阿柏西普,以长期观察治疗性早产儿视网膜病变(ROP)的婴儿。

方法

本回顾性图表研究纳入了有单眼或双眼后极部 1 区 ROP 病史且接受过任何一种抗 VEGF 治疗(包括贝伐单抗、雷珠单抗和阿柏西普)的婴儿,随访时间至少 24 个月。评估内容包括斜视检查、视力测量、屈光和眼轴测量、光学相干断层扫描(OCT)以及眼底荧光素血管造影(FFA)检查。

结果

共纳入 18 例(36 只眼)婴儿,纳入标准为:出生时平均胎龄为 27.8±2.13 周(23-30 周),矫正年龄为 33-61.5 个月(平均:42.58±8.6 个月)。10 只眼接受贝伐单抗治疗,14 只眼接受雷珠单抗治疗,12 只眼接受阿柏西普治疗。平均等效球镜为-0.25±1.82D;眼轴长为 20.81±0.62mm。FFA 检查显示,三组抗 VEGF 药物在视网膜血管异常发育(P=0.183)或渗漏(P=0.842)方面无显著差异。

结论

所有抗 VEGF 药物在轴性和屈光发育方面提供了相似的效果,同时也在周边视网膜产生了相似的异常血管生成。这种异常血管化的周边视网膜的长期影响是一个值得关注的问题。从这一点来看,确定 ROP 抗 VEGF 治疗后的随访时间和方法是非常重要的。

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