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早产儿视网膜病变 4A 期的非手术治疗。

Non-surgical treatment of stage 4A retinopathy of prematurity.

机构信息

Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

BMC Ophthalmol. 2024 Apr 19;24(1):180. doi: 10.1186/s12886-024-03434-5.

Abstract

BACKGROUND

Retinopathy of prematurity (ROP) is a major cause of visual impairment in premature infants, often requiring surgical interventions in advanced stages. This retrospective case series study investigates non-surgical management for Stage 4A ROP, specifically the use of combined laser therapy and intravitreal anti-vascular endothelial growth factor (VEGF) injections.

METHODS

Ten eyes from five infants with Stage 4A ROP were treated with a combined laser and anti-VEGF approach. Comprehensive follow-up examinations were conducted to evaluate the treatment outcomes.

RESULTS

The study demonstrated successful retinal attachment without complications, showcasing the efficacy and safety of this non-surgical method. A comparison with surgical interventions highlighted the potential benefits in terms of reduced adverse effects.

DISCUSSION

This combined treatment emerges as a promising first-choice option for Stage 4A ROP, offering rapid regression without surgical intervention, particularly in early stages. However, larger randomized clinical trials are necessary to validate these findings and establish definitive guidelines for managing this complex condition.

CONCLUSION

Combined laser and anti-VEGF therapy proved to be an effective and safe non-surgical approach for Stage 4A ROP, with the potential to reduce the need for surgery, especially in its early presentation. Further research is required to confirm these findings and provide comprehensive recommendations for clinical practice.

摘要

背景

早产儿视网膜病变(ROP)是早产儿视力损害的主要原因,常需在晚期进行手术干预。本回顾性病例系列研究探讨了 4A 期 ROP 的非手术治疗方法,特别是联合激光治疗和玻璃体内抗血管内皮生长因子(VEGF)注射的应用。

方法

对 5 例 4A 期 ROP 婴儿的 10 只眼采用联合激光和抗 VEGF 方法进行治疗。对治疗结果进行了全面的随访检查。

结果

研究表明,所有患眼均成功实现视网膜附着,无并发症发生,显示了这种非手术方法的疗效和安全性。与手术干预的比较突出了在减少不良反应方面的潜在益处。

讨论

这种联合治疗方法为 4A 期 ROP 提供了一种有前途的首选治疗方案,无需手术干预即可迅速消退,尤其是在早期阶段。然而,需要更大规模的随机临床试验来验证这些发现,并为管理这种复杂疾病制定明确的指南。

结论

联合激光和抗 VEGF 治疗被证明是一种有效且安全的非手术方法,可减少手术的需求,特别是在疾病的早期表现。需要进一步的研究来证实这些发现,并为临床实践提供全面的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edb0/11027283/13b0adcd8cb2/12886_2024_3434_Fig1_HTML.jpg

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