From the Department of Ophthalmology (A.-L.K.C., J.S., I.S.M., C.W., D.K.V., R.M.H., J.D.A., A.B.F.), Boston Children's Hospital, Boston, Massachusetts, USA.
Department of Behavioral Neuroscience (J.S.), Northeastern University, Boston, Massachusetts, USA.
Am J Ophthalmol. 2023 Aug;252:275-285. doi: 10.1016/j.ajo.2023.04.014. Epub 2023 May 3.
Intravitreal injection of bevacizumab (IVB) offers advantages over laser photoablation for treatment of type 1 retinopathy of prematurity (ROP). However, retinal function has not, to date, been quantitatively compared following these interventions. Therefore, electroretinography (ERG) was used compare retinal function among eyes treated using IVB or laser, and control eyes. In addition, among the IVB-treated eyes, ERG was used to compare function in individuals in whom subsequent laser was and was not required.
Prospective clinical cohort study.
ERG was used to record dark- and light-adapted stimulus/response functions in 21 children treated using IVB (12 of whom required subsequent laser in at least 1 eye for persistent avascular retina [PAR]). Sensitivity and amplitude parameters were derived from the a-wave, b-wave, and oscillatory potentials (OPs), representing activity in photoreceptor, postreceptor, and inner retinal cells, respectively. These parameters were then referenced to those of 76 healthy, term-born controls and compared to those of 10 children treated using laser only.
In children with treated ROP, every ERG parameter was significantly below the mean in controls. However, these significant ERG deficits did not differ between IVB- and laser-treated eyes. Among children treated using IVB, no ERG parameter was significantly associated with dose or need for subsequent laser.
Retinal function was significantly impaired in treated ROP eyes. Function in IVB-treated eyes did not differ from that in laser-treated eyes. Functional differences also did not distinguish those IVB-treated eyes that would subsequently need laser for PAR.
与激光光凝相比,玻璃体内注射贝伐单抗(IVB)治疗 1 型早产儿视网膜病变(ROP)具有优势。然而,迄今为止,尚未对这些干预措施后的视网膜功能进行定量比较。因此,本研究使用视网膜电图(ERG)比较了接受 IVB 或激光治疗以及对照组的眼睛的视网膜功能。此外,在接受 IVB 治疗的眼中,还使用 ERG 比较了后续需要和不需要激光治疗的个体的功能。
前瞻性临床队列研究。
使用 ERG 记录了 21 名接受 IVB 治疗的儿童(其中 12 名在至少 1 只眼中因持续性无血管视网膜 [PAR] 需要后续激光治疗)的暗适应和明适应刺激/反应功能。从 a 波、b 波和振荡电位(OPs)中得出敏感性和振幅参数,分别代表光感受器、光感受器后和内视网膜细胞的活动。然后将这些参数与 76 名健康足月出生的对照者的参数进行比较,并与仅接受激光治疗的 10 名儿童的参数进行比较。
在接受治疗的 ROP 儿童中,每个 ERG 参数均明显低于对照组的平均值。然而,IVB 和激光治疗的眼睛之间没有差异。在接受 IVB 治疗的儿童中,没有任何 ERG 参数与剂量或后续激光治疗的需要有显著相关性。
治疗 ROP 眼的视网膜功能明显受损。IVB 治疗的眼睛的功能与激光治疗的眼睛没有区别。功能差异也不能区分那些随后需要激光治疗 PAR 的 IVB 治疗眼。