早产儿视网膜病变激光光凝和雷珠单抗治疗史患儿黄斑区神经节细胞-内丛状层厚度比较

Comparison of the thickness of macular ganglion cell inner plexiform layer in patients with a history of laser photocoagulation versus intravitreal injection of ranibizumab for retinopathy of prematurity

目的对比观察早产儿视网膜病变(ROP)激光光凝(LP)和玻璃体腔注射雷珠单抗(IVR)治疗史患儿的黄斑区神经节细胞-内丛状层(mGCIPL)厚度变化差异。方法回顾性临床研究。2020年6月至2021年1月于深圳市眼科医院就诊且有LP和IVR治疗史的ROP患儿35例70只眼纳入研究。其中,男性18例36只眼,女性17例34只眼;年龄(5.54±1.04)岁。根据接受的治疗方式将其分为LP组、IVR组,分别为18例36只眼和17例34只眼。两组患儿年龄(t=-1.956)、性别构成比(χ^(2)=0.030)、出生胎龄(t=-1.316)、出生体重(t=-1.060)比较,差异均无统计学意义(P=0.059、0.862、0.197、0.297)。所有患眼均行光相干断层扫描(OCT)检查。采用Cirrus HD-OCT 5000的黄斑立方体512×128模式对以黄斑中心凹为中心的14.13 mm2椭圆环形区域进行扫描,设备自带软件获得上方、下方、颞上、颞下、鼻上、鼻下6个扇形区以及平均、最小mGCIPL厚度。两组间mGCIPL厚度比较采用独立样本t检验;mGCIPL厚度与年龄、出生胎龄、出生体重之间的相关性采用Pearson相关性分析。结果与LP组比较,IVR组上方、下方、颞上、颞下、鼻上、鼻下区域以及平均、最小mGCIPL厚度均降低,差异有统计学意义(t=6.484、6.719、7.682、7.697、5.151、5.008、7.148、6.581,P<0.05)。相关性分析结果显示,mGCIPL厚度与年龄、出生胎龄、出生体重均无显著相关性(P>0.05)。结论接受IVR治疗的ROP患儿mGCIPL厚度较接受LP治疗者更薄。

Objective To compare the thickness of the macular ganglion cell inner plexiform layer(mGCIPL)in patients with a history of laser photocoagulation(LP)versus intravitreal injection of ranibizumab(IVR)for retinopathy of prematurity(ROP).Methods A retrospective clinical study.From June 2020 to January 2021,70 eyes of 35 children with a history of surgery for ROP in Shenzhen Eye Hospital were included in the study.Among them,18 males had 36 eyes,and 17 females had 34 eyes.The average age was 5.54±1.04 years.There were 18 patients(36 eyes)in LP group and 17 patients(34 eyes)in IVR group.There was no significant difference in age(t=-1.956),sexual composition ratio(χ^(2)=0.030),birth gestational age(t=-1.316)and birth weight(t=-1.060)between the two groups(P=0.059,0.862,0.197,0.297).All the eyes underwent the examination of optical coherence tomography(OCT).An elliptical region of 14.13 mm2 centered on macular fovea was scanned according to the macular cube 512×128 model of the Cirrus HD-OCT 5000.The software was used to automatically divide macular fovea into six sectors(superior,inferior,temporal-superior,temporal-inferior,nasal-superior and nasal-inferior)and the average and minimum thickness of mGCIPL.t test was used to compared mGCIPL thickness between two groups using independent samples.Pearson correlation analysis was used to evaluate the correlation between mGCIPL thickness and age,birth gestational age,birth weight.Results Patients in IVR group had significantly decreased mGCIPL thickness than that in LP group in the six sectors(superior,inferior,temporal-superior,temporal-inferior,nasal-superior and nasal-inferior)and the average and minimum(t=6.484,6.719,7.682,7.697,5.151,5.008,7.148,6.581;P<0.05).The thickness of mGCIPL was not significantly correlated with age,birth gestational age,birth weight(P>0.05).Conclusion The thickness of mGCIPL in patients with IVR treatment history is thinner than that in LP treatment.