Casey Anthea, Zahra Raihanny Andrea, Barliana Julie Dewi
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Pediatric Ophthalmology Division, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
J Ophthalmic Vis Res. 2024 Jun 21;19(2):246-254. doi: 10.18502/jovr.v19i2.14027. eCollection 2024 Apr-Jun.
The success of vitrectomy in the advanced stages of retinopathy of prematurity (ROP) is defined not only by anatomical results, but also by functional outcomes. Studies have indicated that vitrectomy produces better outcomes when performed at an earlier stage (stage 4 vs. stage 5 ROP). This study reviewed the outcomes of vitrectomy in advanced stages of ROP and the associated factors. PubMed, ScienceDirect, Cochrane, Wiley, and WorldCat databases were systematically searched for articles published in the last 10 years. Studies involving participants with stages 4 and 5 ROP who underwent vitrectomy were included. The final search was performed on March 24, 2023. Risk of bias was assessed using the National Institutes of Health Quality Assessment Tool.The results were presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Ten studies were included in the review. A total of 1179 eyes underwent vitrectomy (72% lens-sparing vitrectomy [LSV] and 28% lensectomy-vitrectomy [LV]). LSV was mainly performed in stage 4 ROP and LV in stage 5 ROP. Anatomical and functional successes were more significant in stages 4A and 4B than in stage 5. Factors that improved prognosis included no plus diseases, stage 4, prior treatments such as laser or intravitreal anti-vascular endothelial growth factor injection, and sparing the lens intraoperatively. Vitrectomy resulted in better outcomes in patients with stage 4 ROP. Early detection and a strict screening protocol are needed to prevent ROP progression into stage 5.
早产儿视网膜病变（ROP）晚期玻璃体切除术的成功不仅取决于解剖学结果，还取决于功能预后。研究表明，玻璃体切除术在早期（ROP 4期与5期）进行时效果更好。本研究回顾了ROP晚期玻璃体切除术的结果及相关因素。系统检索了PubMed、ScienceDirect、Cochrane、Wiley和WorldCat数据库中过去10年发表的文章。纳入了涉及4期和5期ROP患者并接受玻璃体切除术的研究。最终检索于2023年3月24日进行。使用美国国立卫生研究院质量评估工具评估偏倚风险。结果按照《系统评价和Meta分析的首选报告项目2020》指南呈现。本综述纳入了10项研究。共有1179只眼接受了玻璃体切除术（72%为保留晶状体玻璃体切除术[LSV]，28%为晶状体切除玻璃体切除术[LV]）。LSV主要在ROP 4期进行，LV主要在5期进行。4A和4B期的解剖学和功能成功率高于5期。改善预后的因素包括无附加疾病、4期、既往激光或玻璃体内抗血管内皮生长因子注射等治疗以及术中保留晶状体。玻璃体切除术对4期ROP患者效果更好。需要早期检测和严格的筛查方案来防止ROP进展到5期。
