Dwivedi Anamika, Dwivedi Deepak, Lakhtakia Sujata, Charudutt Chalisgaonkar
Department of Ophthalmology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India.
Department of Paediatrics, Shyam Shah Medical College, Rewa, Madhya Pradesh, India.
Oman J Ophthalmol. 2024 Feb 21;17(1):37-42. doi: 10.4103/ojo.ojo_222_22. eCollection 2024 Jan-Apr.
The purpose is to study the anatomical outcome of eyes in aggressive retinopathy of prematurity (AROP), treated with laser photocoagulation alone and to evaluate factors affecting outcomes.
Records of consecutive babies diagnosed with AROP, undergoing laser photocoagulation treatment in rural tertiary care centers from October 2016 to January 2021 were reviewed retrospectively. Anatomical outcome at 6 months follow-up was grouped as good in eyes with complete regression and poor in those who developed retinal detachment (stage IV a, IV b, and V). Both groups were compared with respect to the period of gestation, birth weight (BW), age at screening, age at treatment, zone of disease, presence of retinal fibrovascular proliferation (FVP), tunica vasculosa lentis, preretinal bleed, need for supplement laser, and associated systemic risk factors.
Of the total of 2468 babies screened, 124 (5.02%) were diagnosed with severe retinopathy of prematurity (ROP), of which 54 (43.5%) lasered AROP babies were analyzed. Mean BW and gestation period of the AROP cohort were 1.43 kg and 31.1 weeks, respectively. Eighty-six eyes (79.6%) had good outcomes with laser photocoagulation alone. Posterior location of disease, presence of FVP, neonatal sepsis, shock, and late screening for ROP were found to be factors associated with poor outcomes.
Adequate and timely treatment with laser photocoagulation in AROP can achieve good treatment outcomes in a significant proportion of babies. Although a combined approach using laser, anti-vascular endothelial growth factor and early vitrectomy is better, laser remains a viable treatment option in AROP, especially with limited resources and high risk of loss to follow-up.
研究仅接受激光光凝治疗的侵袭性早产儿视网膜病变（AROP）患儿眼部的解剖学转归，并评估影响转归的因素。
回顾性分析2016年10月至2021年1月在农村三级医疗中心接受激光光凝治疗的连续诊断为AROP的婴儿的记录。6个月随访时的解剖学转归分为完全消退的眼为良好，发生视网膜脱离（IV a期、IV b期和V期）的眼为不良。比较两组在孕周、出生体重（BW）、筛查年龄、治疗年龄、病变区域、视网膜纤维血管增殖（FVP）的存在、晶状体血管膜、视网膜前出血、补充激光的需求以及相关全身危险因素方面的情况。
在总共筛查的2468名婴儿中，124名（5.02%）被诊断为重度早产儿视网膜病变（ROP），其中54名（43.5%）接受激光治疗的AROP婴儿被分析。AROP队列的平均BW和孕周分别为1.43 kg和31.1周。仅激光光凝治疗的86只眼（79.6%）转归良好。发现病变位于后部、存在FVP、新生儿败血症、休克以及ROP筛查延迟是与不良转归相关的因素。
AROP中充分且及时的激光光凝治疗可使相当比例的婴儿获得良好的治疗效果。尽管联合使用激光、抗血管内皮生长因子和早期玻璃体切除术的方法更好，但激光仍是AROP的一种可行治疗选择，尤其是在资源有限且失访风险高的情况下。
