CAJ | 학술논문

目的探讨玻璃体腔注射雷珠单克隆抗体治疗急进型后极部ROP的治疗效果,为临床治疗提供依据.方法回顾性研究.对暨南大学附属深圳市眼科医院2012年1月至2013年10月诊断为急进型后极部ROP的19例(38只眼)早产儿行玻璃体腔注射雷珠单克隆抗体治疗,观察附加病变、嵴、嵴上新生血管的消退情况以及周边视网膜血管发育情况;并对其中7例(14只眼)附加病变、嵴及嵴上新生血管消退不完全者进行激光光凝治疗.结果所有患儿视网膜病变不同程度消退,视网膜血管继续向周边发育.其中12例(24只眼,63.2％)单纯给予玻璃体腔注射雷珠单克隆抗体治疗后病变完全消退,新生血管及出血吸收,血管继续发育至锯齿缘或病变瘢痕化,7例(14只眼,36.8％)病变未消退者联合视网膜光凝治疗后病变完全消退.19例患者中无一例感染,眼部及全身未见其他不良反应.结论玻璃体腔注射雷珠单克隆抗体治疗急进型后极部ROP效果好,不但可以使嵴、嵴上新生血管及附加病变完全消退,而且还可使视网膜血管继续生长,对于病变不能完全消退的患儿可以联合视网膜激光光凝治疗.
목적 탐토파리체강주사뢰주단극륭항체치료급진형후겁부ROP적치료효과,위림상치료제공의거.방법 회고성연구.대기남대학부속심수시안과의원2012년1월지2013년10월진단위급진형후겁부ROP적19례(38지안)조산인행파리체강주사뢰주단극륭항체치료,관찰부가병변、척、척상신생혈관적소퇴정황이급주변시망막혈관발육정황;병대기중7례(14지안)부가병변、척급척상신생혈관소퇴불완전자진행격광광응치료.결과 소유환인시망막병변불동정도소퇴,시망막혈관계속향주변발육.기중12례(24지안,63.2％)단순급여파리체강주사뢰주단극륭항체치료후병변완전소퇴,신생혈관급출혈흡수,혈관계속발육지거치연혹병변반흔화,7례(14지안,36.8％)병변미소퇴자연합시망막광응치료후병변완전소퇴.19례환자중무일례감염,안부급전신미견기타불량반응.결론 파리체강주사뢰주단극륭항체치료급진형후겁부ROP효과호,불단가이사척、척상신생혈관급부가병변완전소퇴,이차환가사시망막혈관계속생장,대우병변불능완전소퇴적환인가이연합시망막격광광응치료.
Objective To observe the retinal vascular development and changes on aggressive posterior retinopathy of prematurity (AP-ROP) by intravitreal ranibizumab, evaluate the therapeutic effect, and provide the basis for clinical treatment.Methods The total of 38 eyes of 19 premature infants who were diagnosed as AP-ROP from January 2012 to October 2013 in our hospital were performed intravitreal injection of ranibizumab (0.04ml).It was observed about the regression of plus diseases, ridges, neovascularization on the ridge and the development of peripheral retinal vessel.Laser photocoagulation were performed for 14 eyes of 7 cases whose plus diseases, ridges and neovascularization on the ridge didn't regress completely after intralvitreal injection of ranibizumab.Results All infants were found retinopathy regressed and retinal vessels continued to develop peripherally to some degree.Of all infants, 24 eyes of 12 infants were found complete regression of retinopathy, resolution of neovascularization and bleeding and that retinal vessels continued to develop to ora serrata or scarification of peripheral retinopathy.Fourteen eyes of 7 infants were found retinopathy didn't regressed completely and regressed completely after combing intravitreal ranibizumab injection.All 19 infants didn't occure infection, ocular or systemic complications.Conclusions The efficacy of intravitreal injection of ranibizumab is good for AP-ROP.It can made ridge, neovascularization on the ridge and plus disease regress, as well as let the retinal vessel continue development.Infants with no regressed retinopathy may need combined laser photocoagulation.