玻璃体腔注射康柏西普治疗早产儿视网膜病变的临床疗效

目的：观察玻璃体腔注射康柏西普治疗早产儿视网膜病变（ROP）的安全性和有效性。方法：回顾性病例研究。选择2015年2月至2016年5月郑州市第二人民医院和登封市妇幼保健院ROP筛查并诊断为 急进性后极部早产儿视网膜病变（AP-ROP）、阈值期ROP或阈值前期1型ROP的患儿26例（52眼）。其中Ⅰ区病变17例，Ⅱ区病变9例。所有患儿在确诊后24 h内玻璃体腔注射10 mg/ml康柏西普0.025 ml （含康柏西普0.25 mg）。随访时间为21～49（31.2±12.5）周。病情复发或对康柏西普治疗无反应者，给予重复康柏西普注射或激光光凝治疗。随访期间观察患儿视网膜血管变化情况以及眼部或全身不良反应发生情况。结果：52眼中，经单次康柏西普治疗有效为46眼（88%），病变完全消退，视网膜血管发育至Ⅲ区。重复康柏西普注射治疗2眼，占4%；经补充激光光凝治疗4眼，占8%，其中3眼病变复发行玻璃体切割术，占所有患眼的6%，纤维增生膜持续加重，发生视网膜脱离，2眼术后视网膜完全复位，1眼术后视网膜部分复位，包括AP-ROP 1眼，阈值期ROP 2眼，均为Ⅱ区病变，复发时间为10～17（13.2±1.8）周。所有患儿随访期间均未发生局部及全身不良反应。结论：康柏西普注射治疗ROP患儿安全有效。部分治疗无反应者，需手术联合激光光凝治疗。

Effects of Intravitreal Injection of Compaq Spray for the Treatment of Retinopathy of Prematurity

Objective: To observe the safety and efficacy of the vitreous cavity injection of compaq for the treatment of retinopathy of prematurity (ROP). Methods: This was a retrospective case study. Twenty-six children (52 eyes) with acute posterior premature retinopathy (AP-ROP), threshold ROP or pre-threshold ROP were diagnosed by ROP screening in Zhengzhou Second People's Hospital and Dengfeng Maternal and Child Health Hospital from February 2015 to May 2016. Seventeen cases (34 eyes) of level Ⅰ lesions and 9 cases (18 eyes) of level Ⅱ lesions were found. All the children were injected with 10 mg/ml of compaq 0.025 ml (25 mg) into the vitreous chamber within 24 h of the diagnosis. The follow-up time was 21-49 weeks with a mean follow-up time of 31.2±12.5 weeks. If there was a disease relapse or no response to treatment with compaq, patients were treated with a repeated compaq injection or laser photo-coagulation. The changes in the retinal vessels of the children were followed and adverse events of the eye or body were monitored. Results: In the 52 eyes, a total of 46 eyes had completerecedingdue toasingle dose of compaq, accounting for 88%. The lesion disappeared completely and the retinal vessels developed to level Ⅲ. Two eyes were treated with a repeated compaq injection (4%) and 4 eyes were treated with supplementary laser photocoagulation (8%). Among these, three eyes were treated with recurrent vitrectomy, accounting for 6% of all eyes. In these eyes, the fibroproliferative membrane continued to aggravate, retinal detachment occurred, the retina completely resetin 2 eyes, and there was a partial reposition of the retina inone eye. This one eye had AP-ROP. Two eyes had threshold ROP with lesions at level Ⅱ. Recurrence times were 10-17 weeks with anaverage recurrence time of 13.2±1.8 weeks. No adverse reactions were observed during the follow-up period. Conclusions: Intraocular injection of compaq is safe and effective in the treatment of children with ROP. Surgery combined with laser photocoagulation is necessary for some unresponsive patients.