玻璃体注射Bevacizumab治疗26例Ⅰ区早产儿视网膜病变

陈　锋,项道满,王建勋,刘　恬



·临床报告·

玻璃体注射Bevacizumab治疗26例Ⅰ区早产儿视网膜病变

陈锋,项道满,王建勋,刘恬

•METHODS:A retrospective study. Totally 26 ROP infants between September 2013 and October 2014 diagnosed as high-risk ROP in Zone Ⅰ had been treated with intravitreal bevacizumab. They were divided into three groups, pre-threshold ROP, threshold ROP and acute posterior ROP (APROP). Postoperative effects were compared.

•RESULTS:There were 26 infants (52 eyes) diagnosed as ROP in Zone Ⅰ, including 3 infants( 6 eyes) with pre-threshold ROP, 15 infants (30 eyes) with threshold ROP and 8 infants (16 eyes) with APROP. The first operation recovery rate of three groups respectively were 100%(6/6), 60%(18/30)and 75%(12/16), which were not significantly different (P>0.05).

•CONCLUSION:Intravitreal bevacizumab for ROP in Zone Ⅰ seems effective and has some advantages over conventional laser treatment, which could be first line treatment for high-risk ROP in Zone Ⅰ.

目的：评价玻璃体注射bevacizumab治疗26例Ⅰ区早产儿视网膜病变(retinopathy of prematurity，ROP)的治疗效果。

方法：通过回顾性研究，对2013-09/2014-10确诊为Ⅰ区阈值期ROP并行玻璃体注射bevacizumab治疗的26例患儿分三组(阈值前期Ⅰ型ROP、阈值期ROP、急进型后极部早产儿视网膜病变-APROP)，进行术后效果分析比较。

结果：治疗Ⅰ区高危性阈值期ROP患儿26例52眼。其中阈值前期Ⅰ型ROP 3例6眼,阈值期ROP 15例30眼,APROP 8例16眼。治疗阈值期Ⅰ型ROP、阈值期ROP和APROP的一次手术治愈率分别为100%(6/6)、60%(18/30)和75%(12/16)，三组之间手术治愈率无统计学差异(P>0.05)。

结论：玻璃体腔内注射bevacizumab治疗Ⅰ区ROP的临床疗效明确，比传统光凝术治疗具有一定优越性，可作为I区ROP的一线治疗方法。

阈值期早产儿视网膜病变；阈值前期早产儿视网膜病变；急性后极部早产儿视网膜病变；玻璃体注射术；bevacizumab

引用：陈锋,项道满,王建勋,等.玻璃体注射Bevacizumab治疗26例Ⅰ区早产儿视网膜病变.国际眼科杂志2016;16(7):1363-1365

0引言

早产儿视网膜病变(retinopathy of prematurity，ROP)是未成熟的视网膜血管异常发育和增生导致的病变, 是引起早产儿致盲的主要原因之一，多见于低孕周和低出生体重的早产儿，在该病发生的敏感时期，由眼科医生对患儿进行常规眼底检查，以便于早期诊断和早期治疗。Ⅰ区ROP常见于急进性后极部早产儿视网膜病变(APROP)、阈值前期ROP和阈值期ROP。此类型的ROP病情发展快，如不及时进行干预治疗易进展至后极部视网膜脱离、黄斑牵引皱襞、晶状体后纤维增生等不良预后的发生率为43%[1]，虽然目前治疗方法很多，但ROP发展至ROP晚期(4期或5期)其疗效有限，很难达到有用视力。因此……