早产儿视网膜病变患儿行玻璃体内注射雷珠单抗后的视功能发育情况  

Visual development of premature infants with retinopathy after intravitreal injection of ranibizumab

作　　者：冯希敏[1] 赵庆新[1] 裴亚欣 刘琳[1] 邵敬芝[2] 张凤妍[2] FENG Ximin;ZHAO Qingxin;PEI Yaxin;LIU Lin;SHAO Jingzhi;ZHANG Fengyan(Department of Ophthalmology,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China;the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]新乡市中心医院眼科,河南省新乡市453000 [2]郑州大学第一附属医院,河南省郑州市450052

出　　处：《眼科新进展》2023年第6期459-462,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81970785);河南省医学科技攻关计划联合共建项目(编号:LHGJ20210918,LHGJ20221006)。

摘　　要：目的观察早产儿视网膜病变(ROP)患儿行玻璃体内注射雷珠单抗后的早期视网膜发育情况及3年后屈光状态。方法选取2017年1月至2019年2月于我院诊治的患儿(50例98眼)并收集其临床资料。依照国际ROP分类标准及干预治疗标准分组:ROP患儿病变达到以上标准并在72 h内尽快完成玻璃体内注射雷珠单抗者25例(48眼)作为雷珠单抗组,选取我院同期性别、出生胎龄及出生体重与雷珠单抗组相匹配的ROP自然退行性变者25例(50眼)作为自然退行性变组。所有患儿依据病情变化,调整随访时间,记录患儿ROP发展变化,观察患儿早期视网膜发育变化,比较两组患儿视网膜完全血管化时间,末次随访时最佳矫正视力(BCVA)、眼轴长度及等效球镜度数。结果两组患儿视网膜完全血管化时间比较,差异有统计学意义(P<0.05)。未次随访时,两组患儿BCVA比较,差异无统计学意义(P>0.05)。未次随访时,两组患儿眼轴长度比较,差异有统计学意义(P<0.05)。末次随访时,两组患儿等效球镜度数比较,自然退行性变组明显高于雷珠单抗组,差异有统计学意义(P<0.05)。结论ROP患儿玻璃体内注射雷珠单抗后,早期虽然取得了明显疗效,但雷珠单抗组视患儿网膜完全血管化时间晚于自然退行性变组,3年后随访,雷珠单抗组较自然退行性变组更偏向近视化。Objective To observe the early retinal development and 3-year refractive status of infants with ROP who received intravitreal injection of ranibizumab.Methods Totally 50 infants(98 eyes)with ROP who were admitted to our hospital from January 2017 to February 2019 were selected,and their clinical data were collected.According to the international ROP classification standard and intervention criteria,25 infants(48 eyes)who met the standards and received intravitreal injection of ranibizumab in 72 h were selected as the ranibizumab group and 25 infants(50 eyes)with natural retrograde degeneration of ROP with the same sex distribution,gestational age and birth weight as the ranibizumab group in the same period were selected as the retrograde degeneration group.The follow-up period for all infants was adjusted according to the changes in conditions.The ROP development was recorded,the early retinal development was observed,and the time to complete retinal vascularization,best corrected visual acuity(BCVA),axial length and spherical equivalent at the last follow-up were compared.Results There was a significant difference in the time to complete retinal vascularization between the two groups(P<0.05).At the last follow-up,there was no significant difference in BCVA between the two groups(P>0.05)but a significant difference in axial length between the two groups(P>0.05).The spherical equivalent of infants in the retrograde degeneration group was significantly higher than that in the ranibizumab group(P<0.05).Conclusion Although infants who received intravitreal injection of ranibizumab show noticeable curative effects in the early stage,the time to complete retinal vascularization of infants in the ranibizumab group is later than that in the retrograde degeneration group.After 3 years,infants in the ranibizumab group are more likely to have myopia than those in the degeneration group.

关 键 词：早产儿视网膜病变 雷珠单抗 视功能发育 屈光状态 

分 类 号：R774.1[医药卫生—眼科]