雷珠单抗治疗早产儿视网膜病变的研究进展

Progress in the Treatment of Retinopathy of Prematurity with Ranibizumab

早产儿视网膜病变(ROP)是一种发生在低出生体重早产儿的视网膜血管发育障碍性疾病,ROP的主要病理特点是与微血管异常相关的正常视网膜血管发育抑制.继2011年贝伐单抗消除异常血管生成的研究后,玻璃体腔注射抗血管内皮生长因子成为ROP的热门治疗方法,为ROP的治疗提供了一种很有前景的选择.与激光治疗相比,避免全麻和破坏性的并发症,从而降低了潜在的风险.考虑到雷珠单抗可能对早产儿有更好的安全性,本文将对玻璃体腔内注射雷珠单抗(IVR)治疗ROP进行综述,主要包括雷珠单抗的治疗剂量、全身安全性、并发症及解剖获益.目前,IVR治疗剂量尚无标准,推荐单次单眼剂量为0.25 mg,但更小剂量(0.15 mg)仍有效且安全,因此,关于治疗剂量仍需要大数据验证.IVR治疗ROP安全、有效,可实现周边网膜完全血管化且获得较好解剖获益,治疗后的主要并发症为视网膜脱离,其他全身并发症罕见.

Retinopathy of Prematurity(ROP)is a kind of retinal vascular dysplasia occurring in low birth weight preterm infants.The main pathological feature of ROP is normal retinal vascular inhibition associated with microvascular abnormalities.Following studies such as the 2011 Bevacizumab Eliminates the Angiogenic Threat(BEAT)-ROP study,intravitreal injection of anti-vascular endothelial growth factor(VEGF)has become a popular treatment for ROP,which provides a promising choice for the treatment of ROP.General anesthesia and destructive complications are avoided compared with lasers,thus reducing the potential risk.Considering that ranibizumab may be more safe for preterm infants,this article will review the intravitreal injection ofranibizumab(IVR)in the treatment of ROP,including the dosage,systemic safety,complications and anatomical benefits of ranibizumab.At present,there is no standard for the treatment dose of IVR,a single eye dose is recommended to be 0.25 mg,but the lower dose(0.15 mg)is still effective and safe.Therefore,the treatment dose still needs to be verified by big data.IVR is safe and effective in the treatment of ROP.Complete vascularization of peripheral omentum and good anatomic benefit can be achieved.Retinal detachment is the main complication after treatment,and other systemic complications are rare.