Successful management of a case of aggressive posterior retinopathy of prematurity(APROP)poorly responsive to laser therapy with intravitreal bevacizumab(IVB)is discussed.IVB is useful as rescue therapy in such cases,...Successful management of a case of aggressive posterior retinopathy of prematurity(APROP)poorly responsive to laser therapy with intravitreal bevacizumab(IVB)is discussed.IVB is useful as rescue therapy in such cases,if given within the correct window period post laser therapy.展开更多
Aggressive posterior retinopathy of prematurity(ROP), previously referred to as "Rush disease", is a rapidly progressive form of ROP. This form of ROP typically presents in very low birth weight babies of ea...Aggressive posterior retinopathy of prematurity(ROP), previously referred to as "Rush disease", is a rapidly progressive form of ROP. This form of ROP typically presents in very low birth weight babies of early gestational age. Historically, anatomical and functional outcomes have been poor with standard treatment. This review is designed to discuss current knowledge and treatment regarding this aggressive form of ROP. Recommendations regarding management of these difficult cases are detailed.展开更多
Background:Laser photocoagulation restricted to ablation of the avascular retina has been the conventional but not a completely effective treatment strategy in the management of threshold retinopathy of prematurity(RO...Background:Laser photocoagulation restricted to ablation of the avascular retina has been the conventional but not a completely effective treatment strategy in the management of threshold retinopathy of prematurity(ROP).The purpose of this study was to compare the structural outcomes of additional posterior to ridge diode laser compared to conventional diode laser to avascular retina alone in threshold stage III ROP.Methods:This was a prospective,randomized study involving infants diagnosed with threshold stage III ROP in one or both the eyes.The infants were randomized into control and study groups.Infants under the control group underwent conventional laser to avascular retina alone while infants under the study group received additional two rows of laser posterior to the ridge in the vascular retina.The infants were followed up at 2 weeks,1 month and up to 6 months after the laser procedure.Results:During the study period of 1 year,42 eyes of 24 infants were recruited into this study with 21 eyes in each group.The mean birth weight was 1,310.48±400.92 g in the test group and 1,341.9±396.2 g in the control group.The mean post conceptional age at the time of intervention was 36.43±2.79 weeks in test group and 36.29±2.55 weeks in the control group.At 1-month post laser,19 eyes in the study group showed regression of neovascularization laser compared to 18 eyes in the control group.However at the end of 3 and 6 months post laser,both groups had showed similar rates regression of neovascularization(19 of 21 eyes in both groups).Five eyes in the study group and six in the control group required additional laser treatment.Two eyes in the study group and one eye in the control group developed post laser vitreous hemorrhage.Conclusions:Posterior to ridge laser treatment for severe stage 3 ROP did not show any additional benefit compared to conventional laser.展开更多
Retinopathy ofprematurity （ROP） is a proliferative disease that affects infants of young gestational age （GA） and low birth weight （BW）. Aggressive posterior ROP （AP-ROP） is a rapidly progressing and severe pr...Retinopathy ofprematurity （ROP） is a proliferative disease that affects infants of young gestational age （GA） and low birth weight （BW）. Aggressive posterior ROP （AP-ROP） is a rapidly progressing and severe presentation of ROP. It is characterized as posterior location （zone 1 or posterior zone I1）, Stage 3, and with plus disease （arterial tortuosity and venous dilation）. It can quickly lead to retinal detachment and blindness if not treated in time.展开更多
目的观察急进型早产儿视网膜病变的综合治疗效果。方法回顾性系列病例研究(Retrospective case study)。选取2015年7月至2020年5月就诊于昆明市儿童医院眼科经眼底筛查诊断为急进型早产儿视网膜病变(A-ROP)的患儿55例(110眼),女性35例,...目的观察急进型早产儿视网膜病变的综合治疗效果。方法回顾性系列病例研究(Retrospective case study)。选取2015年7月至2020年5月就诊于昆明市儿童医院眼科经眼底筛查诊断为急进型早产儿视网膜病变(A-ROP)的患儿55例(110眼),女性35例,男性20例,胎龄24~37(29.47±2.30)周,出生体重730~2250(1322.09±322.75)g,所有患儿均在确诊后48 h内玻璃体腔内注射10 mg/mL雷珠单抗0.025 mL。术后1周,2周,1月,3月,6月,1 a后复查随访6次视网膜情况,随访期间观察患儿眼部情况及全身是否出现不良反应。病情复发或对雷珠单抗治疗无反应者予视网膜激光光凝治疗。注药后到补激光时间为26~48(36.58±5.59)d。并将单次注药有效和注药后补激光分为2组进行比较胎龄、母亲年龄、NICU住院时间、出生体重及吸氧时间作比较,t检验组间差异。结果110眼中经过单次注射雷珠单抗治疗有效为26例患儿52只眼,有效率47.3%,病变完全消退,附加病变消失,无新生血管增生,视网膜血管发育至3区。29例患儿57只眼病变未完全消退,部分患儿出现局部视网膜脱离,周边玻璃体轻微增殖,经补充视网膜激光光凝治疗后病变减轻,附加病变消退,无新生血管增生,视网膜血管发育至3区,占比51.8%,1只眼经注药1周后病变复发,新生血管增加,嵴较前增宽,无血管区范围未见明显缩小,血管未向无血管区继续生长,玻璃体腔内大量增殖膜形成,发生白内障合并视网膜部分脱离,行玻璃体切除及晶状体切除术,术后视网膜完全复位,占比0.9%。单次注药及注药后补激光的两组间胎龄、母亲年龄、NICU住院时间、出生体重及吸氧时间无差异(P>0.05)。所有患儿随访期间未发生眼部及全身不良反应。结论急进型早产儿视网膜病变经积极治疗后效果满意。展开更多
急性进展性后部型早产儿视网膜病变(aggressive posterior retinopathy of prematurity,AP-ROP)是一种少见且进展很快的严重性早产儿视网膜病变,可不遵循1~3期的经典病程,而迅速进展为5期病变,最终导致不可逆的视力丧失。目前常用的治...急性进展性后部型早产儿视网膜病变(aggressive posterior retinopathy of prematurity,AP-ROP)是一种少见且进展很快的严重性早产儿视网膜病变,可不遵循1~3期的经典病程,而迅速进展为5期病变,最终导致不可逆的视力丧失。目前常用的治疗方式有激光光凝、玻璃体腔内注射抗血管内皮生长因子(VEGF)、玻璃体切除术。本文将从以上三个方面入手,对AP-ROP的治疗方式进行综述。展开更多
目的:评价玻璃体注射bevacizumab治疗26例Ⅰ区早产儿视网膜病变(retinopathy of prematurity,ROP)的治疗效果。方法:通过回顾性研究,对2013-09/2014-10确诊为Ⅰ区阈值期ROP并行玻璃体注射bevacizumab治疗的26例患儿分三组(阈值前期Ⅰ型...目的:评价玻璃体注射bevacizumab治疗26例Ⅰ区早产儿视网膜病变(retinopathy of prematurity,ROP)的治疗效果。方法:通过回顾性研究,对2013-09/2014-10确诊为Ⅰ区阈值期ROP并行玻璃体注射bevacizumab治疗的26例患儿分三组(阈值前期Ⅰ型ROP、阈值期ROP、急进型后极部早产儿视网膜病变-APROP),进行术后效果分析比较。结果:治疗Ⅰ区高危性阈值期ROP患儿26例52眼。其中阈值前期Ⅰ型ROP 3例6眼,阈值期ROP 15例30眼,APROP 8例16眼。治疗阈值期Ⅰ型ROP、阈值期ROP和APROP的一次手术治愈率分别为100%(6/6)、60%(18/30)和75%(12/16),三组之间手术治愈率无统计学差异(P>0.05)。结论:玻璃体腔内注射bevacizumab治疗Ⅰ区ROP的临床疗效明确,比传统光凝术治疗具有一定优越性,可作为I区ROP的一线治疗方法。展开更多
目的探讨急进性早产儿视网膜病(retinopathy of prematurity,ROP)与普通型ROP临床特征及发生急进性ROP的影响因素。方法选取2014年1月至2018年12月于深圳市人民医院新生儿病房住院的ROP患儿进行回顾性分析,根据患儿是否达到急进性ROP诊...目的探讨急进性早产儿视网膜病(retinopathy of prematurity,ROP)与普通型ROP临床特征及发生急进性ROP的影响因素。方法选取2014年1月至2018年12月于深圳市人民医院新生儿病房住院的ROP患儿进行回顾性分析,根据患儿是否达到急进性ROP诊断标准分别纳入急进性ROP组和普通型ROP组。收集患儿的临床资料、治疗情况及母亲围生期资料,应用SPSS 18.0统计软件比较两组差异。结果127例ROP患儿中107例为普通型ROP,20例为急进性ROP。普通型ROP组与急进性ROP组胎龄、出生体重比较差异无统计学意义(P>0.05),两组胎龄<32周早产儿分别占91.6%(98/107)和95.0%(19/20),出生体重<1500 g分别占84.1%(90/107)和90.0%(18/20)。普通型ROP组输血≥2次者占53.3%(57/107),急进性ROP组占85.0%(17/20),差异有统计学意义(P<0.05)。普通型ROP组81.3%(87/107)使用机械通气,69.2%(74/107)通气时间≤7 d;急进性ROP组全部使用机械通气,65.0%(13/20)通气时间>7 d。急进性ROP组较普通型ROP组机械通气时间明显延长(P<0.05)。普通型ROP组部分需激光光凝治疗,预后均较好;急进性ROP组治疗多采用玻璃体腔注药,部分需联用激光光凝,大部分预后较好。结论急进性ROP与普通型ROP患儿一般临床特征无明显差异,但输血、机械通气时间延长与急进性ROP发生相关。展开更多
文摘Successful management of a case of aggressive posterior retinopathy of prematurity(APROP)poorly responsive to laser therapy with intravitreal bevacizumab(IVB)is discussed.IVB is useful as rescue therapy in such cases,if given within the correct window period post laser therapy.
文摘Aggressive posterior retinopathy of prematurity(ROP), previously referred to as "Rush disease", is a rapidly progressive form of ROP. This form of ROP typically presents in very low birth weight babies of early gestational age. Historically, anatomical and functional outcomes have been poor with standard treatment. This review is designed to discuss current knowledge and treatment regarding this aggressive form of ROP. Recommendations regarding management of these difficult cases are detailed.
文摘Background:Laser photocoagulation restricted to ablation of the avascular retina has been the conventional but not a completely effective treatment strategy in the management of threshold retinopathy of prematurity(ROP).The purpose of this study was to compare the structural outcomes of additional posterior to ridge diode laser compared to conventional diode laser to avascular retina alone in threshold stage III ROP.Methods:This was a prospective,randomized study involving infants diagnosed with threshold stage III ROP in one or both the eyes.The infants were randomized into control and study groups.Infants under the control group underwent conventional laser to avascular retina alone while infants under the study group received additional two rows of laser posterior to the ridge in the vascular retina.The infants were followed up at 2 weeks,1 month and up to 6 months after the laser procedure.Results:During the study period of 1 year,42 eyes of 24 infants were recruited into this study with 21 eyes in each group.The mean birth weight was 1,310.48±400.92 g in the test group and 1,341.9±396.2 g in the control group.The mean post conceptional age at the time of intervention was 36.43±2.79 weeks in test group and 36.29±2.55 weeks in the control group.At 1-month post laser,19 eyes in the study group showed regression of neovascularization laser compared to 18 eyes in the control group.However at the end of 3 and 6 months post laser,both groups had showed similar rates regression of neovascularization(19 of 21 eyes in both groups).Five eyes in the study group and six in the control group required additional laser treatment.Two eyes in the study group and one eye in the control group developed post laser vitreous hemorrhage.Conclusions:Posterior to ridge laser treatment for severe stage 3 ROP did not show any additional benefit compared to conventional laser.
文摘Retinopathy ofprematurity （ROP） is a proliferative disease that affects infants of young gestational age （GA） and low birth weight （BW）. Aggressive posterior ROP （AP-ROP） is a rapidly progressing and severe presentation of ROP. It is characterized as posterior location （zone 1 or posterior zone I1）, Stage 3, and with plus disease （arterial tortuosity and venous dilation）. It can quickly lead to retinal detachment and blindness if not treated in time.
文摘急性进展性后部型早产儿视网膜病变(aggressive posterior retinopathy of prematurity,AP-ROP)是一种少见且进展很快的严重性早产儿视网膜病变,可不遵循1~3期的经典病程,而迅速进展为5期病变,最终导致不可逆的视力丧失。目前常用的治疗方式有激光光凝、玻璃体腔内注射抗血管内皮生长因子(VEGF)、玻璃体切除术。本文将从以上三个方面入手,对AP-ROP的治疗方式进行综述。
