广域眼底成像在早产儿视网膜病变激光治疗中的应用

Application of wide-field imaging system in laser treatment for retinopathy of prematurity

目的观察广域眼底成像在早产儿视网膜病变(ROP)激光治疗中的应用价值。方法选取2017年2月至2020年8月在安徽省妇幼保健院确诊为ROP的33例60眼纳入研究。60眼ROP均在间接眼底镜下接受了初始激光光凝治疗,治疗后立即通过广域眼底成像识别所有的无血管区和激光遗漏区,并对遗漏区域补充光凝。治疗后1周内复查,平均随访5.5个月。随访期间主要观察光凝范围、光凝有无遗漏及病变是否消退或进展。结果激光治疗60眼中共发现9个激光遗漏区,主要分布在嵴周或颞侧,对遗漏区及时补充光凝。术后1周复查,未发现光凝遗漏区,术后远期复查所有病变均消退。结论广域眼底成像实现了视网膜的可视化,准确识别初始激光可能遗漏的区域,及时补充光凝以减少ROP因光凝不足需再次治疗的可能性。

Objective To observe the application value of wide-angle imaging system in laser treatment of retinopathy of prematurity(ROP).Methods Sixty eyes of 33 patients diagnosed with ROP in Anhui Maternal and Child Health Hospital from February 2017 to August 2020 were included in the study.All 60 eyes with ROP received initial laser photocoagulation treatment under indirect fundus microscopy.Immediately after treatment,all vascularless areas and laser missing areas were identified by wide-field fundus imaging,and photocoagulation was added to the missing areas.The patients were reexamined within 1 week after treatment and were followed up for an average of 5.5 months During the follow-up period,the scope of photocoagulation,the absence of photocoagulation and the regression or progression of lesions were mainly observed.Results A total of 9 skip areas were identified in the 60 eyes treated with laser photocoagulation.Most skip areas occurred in the temporalretina or the next to the ridge.No missing area of photocoagulation was found one week after surgery,and all lesions were subtracted after long-term review.Conclusions Wide-field imaging can assist ophthalmologists in visualizing all regions of the retina,and identify the skip areas afterl laser photocoagulation.Thus,wide-field imaging may potentially reduce the need for the retreatment of skip areas after initial laser for ROP.