Jones Anthony A, Martin Jacob S, Giangiacomo Annette L, Costakos Deborah M
Department of Ophthalmology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, USA.
Department of Pediatric Ophthalmology, Children's Hospital Milwaukee, 8915 W Connell Ct, Milwaukee, WI 53226, USA.
Am J Ophthalmol Case Rep. 2024 Jul 25;36:102131. doi: 10.1016/j.ajoc.2024.102131. eCollection 2024 Dec.
The authors report three separate cases of type 1 retinopathy of prematurity (ROP) treated with intravitreal bevacizumab before, or at 34 weeks postmenstrual age (PMA), with subsequent development of secondary glaucoma.
All three cases involve patients born ≤24 weeks and meeting the American Academy of Pediatrics criteria for ROP screening. Prior to treatment, each patient was noted to have normal anterior chamber structures with no signs of glaucoma. Each patient developed type 1 ROP and was treated with intravitreal bevacizumab, which was administered at or before 34 weeks PMA. Following the administration of intravitreal anti-vascular endothelial growth factor (VEGF), each patient developed a suspected open-angle glaucoma (OAG) within an approximate 4-week time frame. In these cases, the presentation of glaucoma differed from those that have been previously reported in the literature.
Based on similar timing of glaucoma development following intravitreal bevacizumab injections, we hypothesize that the administration of anti-VEGF agents to very premature infants (≤24 weeks) at or before 34 weeks PMA, may predispose them to the development of secondary glaucoma through an unknown and possibly novel pathway.
作者报告了三例分别在孕龄34周前或孕龄34周时接受玻璃体内注射贝伐单抗治疗的1型早产儿视网膜病变（ROP）病例，随后均发生了继发性青光眼。
所有三例病例均为出生时孕周≤24周且符合美国儿科学会ROP筛查标准的患者。治疗前，每位患者前房结构均正常，无青光眼迹象。每位患者均发生了1型ROP，并在孕龄34周或之前接受了玻璃体内贝伐单抗治疗。在玻璃体内注射抗血管内皮生长因子（VEGF）后，每位患者均在大约4周的时间内发生了疑似开角型青光眼（OAG）。在这些病例中，青光眼的表现与先前文献报道的不同。
基于玻璃体内注射贝伐单抗后青光眼发生时间相似，我们推测在孕龄34周或之前对极早产儿（≤24周）使用抗VEGF药物，可能通过未知且可能是新的途径使他们易患继发性青光眼。
