荧光素眼底血管造影在3区ROP治疗中应用观察

Fundus fluorescein angiography in the treatment of Zone Ⅲ Retinopathy of Prematurity

目的观察荧光素眼底血管造影在3区ROP治疗中的应用价值,为临床3区ROP的治疗提供依据。方法收集2017年1~12月在我院筛查并诊断为3区1~3期ROP患者21例42只眼,男11例,女10例纳入研究。所有患儿全麻下使用三代广角数码视网膜成像系统(RetCamШ)完成荧光素眼底血管造影检查,检查中如发现荧光渗漏、"爆米花"样改变,即刻行810 nm激光光凝治疗,并于治疗后1、4、8、12周进行复查,以后每6个月复查1次,观察ROP病变的消退及进展情况。计量资料采用SPSS13.0统计学软件分析,结果以均数±标准差(x±s)表示。结果21例42只眼中12例22只眼,颞侧视网膜血管末梢分支数量增多,血管迂曲、粗细不均,以静脉为主,呈毛刷样分布,末端血管相互吻合形成短路,并呈嵴样改变,在嵴上或嵴后可见"爆米花"样强荧光改变,伴有明显荧光渗漏,故行激光治疗。另20只眼,颞侧视网膜血管末梢分支增多、迂曲,呈"毛刷"样、"羽翼"样改变,血管化区与无血管化区分界明显,造影晚期无荧光渗漏,未行激光治疗。激光术后患儿随访中未见病情进展,激光斑形成良好,嵴及血管迂曲消退。结论荧光素眼底血管造影能清晰显示3区ROP病变活动程度,对3区ROP病变的治疗具有良好的指导价值。

Objective To describe the characteristics of fundus fluorescein angiography in Zone Ⅲ retinopathy of prematurity(ROP)and lay the foundation of clinical treatment for ROP.Methods From January to December 2017,42 eyes of 21 cases of stage 1-3 ROP were screened and diagnosed in our hospital were be collected.There were 11 males and 1o females.RetCam Ⅲ were used to complete the fluorescein fundus angiography for all children under general anesthesia.If found in the inspection of fluorescence leakage,"popcorn"kind of change immediately 810nm laser photocoagulation.After treatment,fundus examination was performed at 1 week,4 weeks,8 weeks and 12 weeks respectively,and every 6 months thereafter.The regression and progression of ROP were observed.SPSS13.0 statistical software analysis was used for data measurement,the results were mean+standard deviation(x±s)said.Results 42 eyes of 21 cases were examined by fluorescein fundus angiography,which 22 eyes of 12 cases,the number of branches of temporal retinal vessels increased,blood vessels tortuous,uneven thickness,mainly vein and brush-like distribution,and the peripheral vascular coincide with each other to form a short circuit,and showed ridge-like changes,with significant fluorescence leakage,visible in the crest or ridge crest,popcorn-like fluorescence change,so retinal laser treatment.The other 20 eyes,the temporal retinal blood vessels distal branches increased,tortuous,with"brush"like or"wing"like changes,vascularization and vascularization area clear distinction between late non-fluorescent angiography leakage,so no laser treatment were comformed.Follow-up no progress of the disease,the formation of a good laser class,ridges and blood vessels circuitous subsided.Conclusions The activity of Zone Ⅲ ROP is clearly observed on fundus fluorescein angiography.It is a good guide to the value of the treatment for zone 3 ROP lesions.