玻璃体腔注射雷珠单克隆抗体治疗急进型后极部早产儿视网膜病变的临床疗效观察  

The clinical study on intravitreous injection of ranibizumab for aggressive posterior retinopathy of prematurity

作　　者：田汝银[1] 张国明[1] 唐松[1] 郭金莲[1] 谭文静[1] 

机构地区：[1]暨南大学附属深圳市眼科医院深圳眼科学重点实验室,518040

出　　处：《中华眼科杂志》2015年第11期822-825,共4页Chinese Journal of Ophthalmology

基　　金：深圳市科技创新委员会重点项目（201101024）;深圳市科技创新委员会基础研究项目（JCYJ20140415174819511）

摘　　要：目的 探讨玻璃体腔注射雷珠单克隆抗体治疗急进型后极部ROP的治疗效果,为临床治疗提供依据.方法 回顾性研究.对暨南大学附属深圳市眼科医院2012年1月至2013年10月诊断为急进型后极部ROP的19例（38只眼）早产儿行玻璃体腔注射雷珠单克隆抗体治疗,观察附加病变、嵴、嵴上新生血管的消退情况以及周边视网膜血管发育情况;并对其中7例（14只眼）附加病变、嵴及嵴上新生血管消退不完全者进行激光光凝治疗.结果 所有患儿视网膜病变不同程度消退,视网膜血管继续向周边发育.其中12例（24只眼,63.2％）单纯给予玻璃体腔注射雷珠单克隆抗体治疗后病变完全消退,新生血管及出血吸收,血管继续发育至锯齿缘或病变瘢痕化,7例（14只眼,36.8％）病变未消退者联合视网膜光凝治疗后病变完全消退.19例患者中无一例感染,眼部及全身未见其他不良反应.结论 玻璃体腔注射雷珠单克隆抗体治疗急进型后极部ROP效果好,不但可以使嵴、嵴上新生血管及附加病变完全消退,而且还可使视网膜血管继续生长,对于病变不能完全消退的患儿可以联合视网膜激光光凝治疗.Objective To observe the retinal vascular development and changes on aggressive posterior retinopathy of prematurity （AP-ROP） by intravitreal ranibizumab, evaluate the therapeutic effect, and provide the basis for clinical treatment.Methods The total of 38 eyes of 19 premature infants who were diagnosed as AP-ROP from January 2012 to October 2013 in our hospital were performed intravitreal injection of ranibizumab （0.04ml）.It was observed about the regression of plus diseases, ridges, neovascularization on the ridge and the development of peripheral retinal vessel.Laser photocoagulation were performed for 14 eyes of 7 cases whose plus diseases, ridges and neovascularization on the ridge didn＇t regress completely after intralvitreal injection of ranibizumab.Results All infants were found retinopathy regressed and retinal vessels continued to develop peripherally to some degree.Of all infants, 24 eyes of 12 infants were found complete regression of retinopathy, resolution of neovascularization and bleeding and that retinal vessels continued to develop to ora serrata or scarification of peripheral retinopathy.Fourteen eyes of 7 infants were found retinopathy didn＇t regressed completely and regressed completely after combing intravitreal ranibizumab injection.All 19 infants didn＇t occure infection, ocular or systemic complications.Conclusions The efficacy of intravitreal injection of ranibizumab is good for AP-ROP.It can made ridge, neovascularization on the ridge and plus disease regress, as well as let the retinal vessel continue development.Infants with no regressed retinopathy may need combined laser photocoagulation.

关 键 词：早产儿视网膜病 抗体 单克隆 人 玻璃体内注射 血管内皮生长因子A 

分 类 号：R774.1[医药卫生—眼科]