玻璃体内注射康柏西普治疗急进性后极部早产儿视网膜病变早期眼压的改变  

Intraocular pressure changes in early stage of aggressive posterior retinopathy of prematurity treated by vitreous injection of conbercept

作　　者：傅征 杨晖 洪志斌 尹雪 熊薇薇 王娜 FU Zheng;YANG Hui;HONG Zhibin;YIN Xue;XIONG Weiwei;WANG Na(Department of Ophthalmology,Xiamen Children’s Hospital,Xiamen 361000,Fujian Province,China)

机构地区：[1]厦门市儿童医院眼科,福建省厦门市361000

出　　处：《眼科新进展》2021年第1期62-65,共4页Recent Advances in Ophthalmology

基　　金：厦门市科技局惠民项目(编号3502Z20189046)。

摘　　要：目的探讨玻璃体内注射康柏西普治疗急进性后极部早产儿视网膜病变(AP-ROP)患儿早期眼压的改变。方法选取2017年6月至2019年5月于厦门市儿童医院确诊的AP-ROP行玻璃体内注射康柏西普(0.25 mg/0.025 mL)治疗的22例(32眼)患儿纳入研究。分别记录注射前5 min及注射后1 min、5 min、10 min、2 h、24 h眼压,同时记录注射后疗效并分析并发症情况。结果22例(32眼)患儿注射前5 min眼压为(10.44±2.68)mmHg(1 kPa=7.5 mmHg),注射后1 min、5 min、10 min、2 h及24 h的眼压分别为(18.66±3.09)mmHg、(21.81±3.09)mmHg、(18.34±3.26)mmHg、(14.53±3.29)mmHg、(12.03±3.36)mmHg。方差分析结果显示,不同时间点间的眼压差异具有统计学意义(F=61.91,P<0.01);两两时间点比较结果显示,注射后10 min与注射后1 min、注射后24 h与注射前5 min眼压相比差异均无统计学意义(均为P>0.05),其余各观察时间点间眼压两两相比差异均有统计学意义(均为P<0.05)。注射后各时间点眼压的变化趋势为先升后降,眼压峰值出现在注射后5 min。患儿注射后5 min眼压较注射前升高幅度≥15 mmHg的患眼,其合并虹膜新生血管的比例更高,出生体质量更低(均为P<0.05)。结论玻璃体内注射康柏西普治疗AP-ROP患儿出现的眼压升高是一过性的,眼科临床医生需多关注注射后5 min的眼压,以避免因为眼压升高影响术后效果。Objective To investigate changes in intraocular pressure(IOP)after intravitreal conbercept(IVC)administration to infants with aggressive posterior retinopathy of prematurity(AP-ROP).Methods Retrospective analysis.From June 2017 to May 2019,22 patients(32 eyes)of AP-ROP diagnosed in Xiamen Children’s Hospital who received intravitreal injection of conbercept(0.25 mg/0.025 mL)were included in the study.IOP was measured and recorded at 5 minutes before operation,1 minute,5 minutes,10 minutes,2 hours and 24 hours after operation.Results The IOP of 32 eyes of children was(10.44±2.68)mmHg(1 kPa=7.5 mmHg)at 5 min before injection,and(18.66±3.09)mmHg,(21.81±3.09)mmHg,(18.34±3.26)mmHg,(14.53±3.29)mmHg,(12.03±3.36)mmHg at 1 minute,5 minutes,10 minutes,2 hours and 24 hours after injection.The results of analysis of variance showed that the difference in IOP between different time points was statistically significant(F=61.91,P<0.01).The comparison between the two time points showed that there were no significant differences in IOP between 10 minutes and 1 minute after injection,24 hours after injection and 5 minute before injection(both P>0.05),while there were statistically significant differences in the pairwise comparison between the other time points(all P<0.05).The change trend of IOP in each time period was firstly increased and then decreased,and the peak IOP was 5 minutes after injection.Children whose IOP increased by≥15 mmHg 5 minutes after injection had a higher proportion of combined iris neovascularization and lower birth weight(both P<0.05).Conclusion In the treatment of AP-ROP by intravitreal injection of conbercept,the elevated IOP is non fluctuating and transient.Ophthalmologists should pay more attention to IOP(5 minutes after operation)to avoid the influence of elevated IOP on postoperative efficacy.

关 键 词：急进性后极部早产儿视网膜病变 玻璃体内注射 康柏西普 眼压 虹膜新生血管 

分 类 号：R779.7[医药卫生—眼科]