Wu Feng-Yue, Yu Wen-Ting, Zhao Dai-Xin, Pu Wei, Zhang Xue, Gai Chun-Liu
Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.
Department of Neonatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.
Int J Ophthalmol. 2023 Jan 18;16(1):95-101. doi: 10.18240/ijo.2023.01.14. eCollection 2023.
To identify risk factors of recurrence of this disorder after intravitreal ranibizumab (IVR) monotherapy.
Totally 33 eyes of 19 patients who underwent initial IVR treatments for type 1 retinopathy of prematurity (ROP) at our center were retrospectively reviewed between April 1, 2016 and December 31, 2017. Patient demographics, the side of ROP, multiple gestations, Apgar scores, zone, stage, plus disease, postmenstrual age at injection, surfactant therapy, blood transfusion therapy, hemorrhage before IVR, hemorrhage after IVR, gestational diabetes mellitus, pregnancy-induced hypertension, anemia, intraventricular hemorrhage, sepsis, respiratory distress syndrome, carbohemia, and congenital heart defects were recorded. Adjusted hazard ratios (HRs) and 95% confidence intervals were determined after adjusting for potential confounders using multivariate proportional Cox regression.
Of the 33 eyes, 12 (36.4%) had ROP recurrences 45.3 (5.1, 50.9)mo after initial IVR treatments. The independent risk factors for ROP recurrences were zone (II I, HR: 0.056, =0.003) and gestational diabetes mellitus (no yes, HR: 0.095, <0.001). The mean uncorrected visual acuity for four recurrence eyes was 0.46 logMAR (0.13, 0.70) at 55.0 (51.0, 58.9) mo after the initial IVR treatment. The mean uncorrected visual acuity for 10 eyes without recurrence was 0.46 logMAR (0.19, 0.63) at 48.0 (43.8, 58.4) mo after the initial IVR treatment.
Two independent risk factors for type 1 ROP recurrence after IVR treatment involving zone I and gestational diabetes mellitus are identified, and the mean uncorrected visual acuity is 0.46 logMAR at 51.0 (44.0, 58.9)mo. The findings of this study are important for follow-up management and for improving the visual function of ROP patients.
确定玻璃体内注射雷珠单抗（IVR）单药治疗后该疾病复发的危险因素。
回顾性分析2016年4月1日至2017年12月31日期间在本中心接受初次IVR治疗1型早产儿视网膜病变（ROP）的19例患者的33只眼。记录患者人口统计学资料、ROP部位、多胎妊娠、阿氏评分、区域、分期、附加病变、注射时的月经后年龄、表面活性剂治疗、输血治疗、IVR前出血、IVR后出血、妊娠期糖尿病、妊娠高血压、贫血、脑室内出血、败血症、呼吸窘迫综合征、高碳酸血症和先天性心脏缺陷。使用多变量比例Cox回归对潜在混杂因素进行校正后，确定校正风险比（HR）和95%置信区间。
33只眼中，12只（36.4%）在初次IVR治疗后45.3（5.1，50.9）个月出现ROP复发。ROP复发的独立危险因素为区域（II区比I区，HR：0.056，P = 0.003）和妊娠期糖尿病（无糖尿病比有糖尿病，HR：0.095，P < 0.001）。4只复发眼在初次IVR治疗后55.0（51.0，58.9）个月时的平均未矫正视力为0.46 logMAR（0.13，0.70）。10只未复发眼在初次IVR治疗后48.0（43.8，58.4）个月时的平均未矫正视力为0.46 logMAR（0.19，0.63）。
确定了涉及I区和妊娠期糖尿病的IVR治疗后1型ROP复发的两个独立危险因素，在51.0（44.0，58.9）个月时平均未矫正视力为0.46 logMAR。本研究结果对随访管理和改善ROP患者的视功能具有重要意义。
