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比较三种剂量贝伐单抗治疗 1 型早产儿视网膜病变的再激活和再治疗。

Comparing reactivation and retreatment for three doses of bevacizumab in type 1 retinopathy of prematurity.

机构信息

Indiana University School of Medicine, Indianapolis.

Department of Ophthalmology, Indiana University School of Medicine, Indianapolis.

出版信息

J AAPOS. 2024 Apr;28(2):103866. doi: 10.1016/j.jaapos.2024.103866. Epub 2024 Mar 6.

Abstract

PURPOSE

To determine timing and rates of reactivation and retreatment of type 1 retinopathy of prematurity (ROP) after treatment with either 0.125 mg, 0.250 mg, or 0.500 mg of intravitreal bevacizumab (IVB).

METHODS

Retrospective data, including demographic information, past medical history, and ROP characteristics were analyzed for babies with type 1 ROP treated with IVB at Riley Hospital for Children for the perioed 2014-2021.

RESULTS

A total of 84 patients met inclusion criteria: 29 patients received 0.125 mg of IVB; 39, 0.250 mg; and 16, 0.500 mg. Of the 84, 67 (80%) had additional laser treatment because of late reactivation (n = 52) or persistent avascular retina (PAR) (n = 15). Subsequent laser treatment was more common with lower doses: 0.125 mg (n = 27 [93%]); 0.250 mg (n = 31 [80%]); 0.500 mg (n = 9 [57%]) (P = 0.012). There was no difference between groups with regard to reason for subsequent laser treatment (reactivation vs PAR). The 0.125 mg group required retreatment because of reactivation 3.8 weeks sooner than the other dosing groups (P = 0.047).

CONCLUSIONS

The outcomes comparing three doses of IVB for severe ROP showed a difference in the timing of secondary treatment, with the lower dosing group requiring laser for reactivation earlier.

摘要

目的

确定使用 0.125mg、0.250mg 或 0.500mg 玻璃体内注射贝伐单抗(IVB)治疗 1 型早产儿视网膜病变(ROP)后的再激活和再治疗的时间和比率。

方法

回顾性分析了 2014 年至 2021 年期间在 Riley 儿童医院接受 IVB 治疗的 1 型 ROP 婴儿的人口统计学信息、既往病史和 ROP 特征等数据。

结果

共有 84 名患者符合纳入标准:29 名患者接受 0.125mg IVB;39 名患者接受 0.250mg;16 名患者接受 0.500mg。在这 84 名患者中,67 名(80%)因晚期再激活(n=52)或持续性无血管视网膜(PAR)(n=15)而接受了额外的激光治疗。较低剂量的患者更常见需要后续激光治疗:0.125mg(n=27[93%]);0.250mg(n=31[80%]);0.500mg(n=9[57%])(P=0.012)。两组间后续激光治疗的原因(再激活与 PAR)无差异。0.125mg 组因再激活而需要再治疗的时间比其他剂量组早 3.8 周(P=0.047)。

结论

比较三种剂量 IVB 治疗严重 ROP 的结果显示,二次治疗的时机存在差异,较低剂量组因再激活而需要激光治疗的时间更早。

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本文引用的文献

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J AAPOS. 2021 Jun;25(3):180-184. doi: 10.1016/j.jaapos.2021.02.004. Epub 2021 May 6.
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Short-term Outcomes After Very Low-Dose Intravitreous Bevacizumab for Retinopathy of Prematurity.
JAMA Ophthalmol. 2020 Jun 1;138(6):698-701. doi: 10.1001/jamaophthalmol.2020.0334.
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Ophthalmic Surg Lasers Imaging Retina. 2018 Aug 1;49(8):625-628. doi: 10.3928/23258160-20180803-11.
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Ultra-low-dose intravitreal bevacizumab for the treatment of retinopathy of prematurity: a case series.
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Recurrence of Retinopathy of Prematurity After Intravitreal Ranibizumab Monotherapy: Timing and Risk Factors.
Invest Ophthalmol Vis Sci. 2017 Mar 1;58(3):1719-1725. doi: 10.1167/iovs.16-20680.
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