Tan Ting Fang, Tay Su Ann, Agarwal-Sinha Swati, Tan Gavin Siew Wei, Wu Wei-Chi, Tsai Andrew S H
Singapore National Eye Centre, Singapore Eye Research Institute, Singapore, Singapore.
KK Women'S and Children'S Hospital, Singapore, Singapore.
Graefes Arch Clin Exp Ophthalmol. 2025 Apr 3. doi: 10.1007/s00417-025-06820-x.
Persistent avascular retina (PAR) has been increasingly reported with the increased use of anti-vascular endothelial growth factor (VEGF) agents in treatment-requiring ROP. However, they have also been observed in ROP eyes that did not meet treatment requirement and spontaneously regressed. PAR is highlighted in the updated nomenclature under the International Classification of Retinopathy of Prematurity, 3rd edition (ICROP3) consensus statement, underscoring the increased emphasis in detecting PAR. PAR has been noted to persist beyond existing ROP screening guidelines, and were found to be associated with complications like retinal tear and detachment, especially in eyes with more posterior PAR. Thus, serial monitoring of retinal vascularization, facilitated by fluorescein angiography and wide-field imaging, for these associated complications have been encouraged. The current lack of consensus in the follow-up and management of PAR prompts further work in this area: understanding the natural course of retinal vascularization in both untreated and treated ROP, the modulation of anti-VEGF on retinal function, and the clinical significance of PAR-associated vascular patterns can help to guide management protocols for PAR in ROP eyes.
随着抗血管内皮生长因子（VEGF）药物在需要治疗的早产儿视网膜病变（ROP）中使用的增加，持续性无血管视网膜（PAR）的报道越来越多。然而，在不符合治疗要求且自行消退的ROP眼中也观察到了PAR。在《早产儿视网膜病变国际分类》第3版（ICROP3）共识声明的更新术语中强调了PAR，这突出了对检测PAR的日益重视。已经注意到PAR持续超过现有的ROP筛查指南，并且发现其与视网膜撕裂和脱离等并发症相关，特别是在PAR更靠后的眼中。因此，鼓励通过荧光素血管造影和广角成像对视网膜血管化进行连续监测，以发现这些相关并发症。目前在PAR的随访和管理方面缺乏共识，这促使在该领域开展进一步的工作：了解未经治疗和接受治疗的ROP中视网膜血管化的自然病程、抗VEGF对视网膜功能的调节以及PAR相关血管模式的临床意义，有助于指导ROP眼中PAR的管理方案。
