Ünal Ayşe Cengiz, Akıdan Melih, Erol Muhammet Kazım
Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, 07050, Turkey.
Department of Ophthalmology, Antalya Akseki State Hospital, Antalya, Turkey.
Sci Rep. 2024 Dec 28;14(1):31097. doi: 10.1038/s41598-024-82445-0.
Our current prospective cross-sectional study aimed to investigate the effect of anti-vascular endothelial growth factor (VEGF) drugs used in the treatment of retinopathy of prematurity on retinal maturation and persistent avascular retina (PAR). Retinal imaging was performed with Optos confocal laser ophthalmoscopy for 100 patients aged 4 to 8 years who were screened and treated for retinopathy of prematurity (ROP) during the neonatal period. The ROP examination findings (stage and zone) and treatment history (age in weeks at time of treatment and anti-VEGF drug used) from the neonatal period were reviewed. Retinal vascularization was assessed in fundus images using the green filter on the Optos device and the presence of PAR was evaluated by two investigators. Relationships between the rate of PAR, age in weeks at time of treatment, and type of anti-VEGF drug used were analyzed statistically. The study included 196 eyes of 100 patients. Sixty-four eyes were analyzed in Group 1 (no ROP), 23 eyes in Group 2 (ROP, no treatment), and 108 eyes in Group 3 (treated group; anti-VEGF treatment of ROP with ranibizumab, bevacizumab, or aflibercept). The number of eyes with PAR in these groups was 2 (3.7%), 4 (17.4%), and 45 (41.7%), respectively. PAR was detected in 30 of 44 eyes treated with aflibercept. The rate of PAR was higher after aflibercept treatment (68.2%) with statistical significance (p = 0.000). This study showed that the prevalence of PAR differs between anti-VEGF drugs. Patients treated with aflibercept have a higher risk of late complications and should be followed closely.
我们当前的前瞻性横断面研究旨在调查用于治疗早产儿视网膜病变的抗血管内皮生长因子（VEGF）药物对视网膜成熟和持续性无血管视网膜（PAR）的影响。对100名年龄在4至8岁的患者进行了Optos共焦激光检眼镜视网膜成像检查，这些患者在新生儿期接受过早产儿视网膜病变（ROP）的筛查和治疗。回顾了新生儿期的ROP检查结果（分期和分区）以及治疗史（治疗时的周龄和使用的抗VEGF药物）。使用Optos设备上的绿色滤光片在眼底图像中评估视网膜血管化情况，并由两名研究人员评估PAR的存在情况。对PAR发生率、治疗时的周龄和使用的抗VEGF药物类型之间的关系进行了统计学分析。该研究纳入了100名患者的196只眼。第1组（无ROP）分析了64只眼，第2组（ROP，未治疗）分析了23只眼，第3组（治疗组；使用雷珠单抗、贝伐单抗或阿柏西普对ROP进行抗VEGF治疗）分析了108只眼。这些组中PAR阳性的眼数分别为2只（3.7%）、4只（17.4%）和45只（41.7%）。在接受阿柏西普治疗的44只眼中，有30只检测到PAR。阿柏西普治疗后PAR发生率较高（68.2%），具有统计学意义（p = 0.000）。本研究表明，不同抗VEGF药物之间PAR的患病率存在差异。接受阿柏西普治疗的患者发生晚期并发症的风险较高，应密切随访。
