雷珠单抗玻璃体内注射治疗1型阈值前病变早产儿视网膜病变疗效观察

目的观察雷珠单抗玻璃体内注射治疗1型阈值前病变早产儿视网膜病变(retinopathy of prematurity,ROP)的疗效。方法回顾性分析2016年4月至2017年8月在我院眼科检查确诊并接受雷珠单抗玻璃体内注射治疗的1型阈值前病变ROP患儿,所有患儿在确诊后72 h内行雷珠单抗0.25 mg/0.025 mL玻璃体内注射,首次注药后2 d、1周、2周以及接下来根据患儿病情决定随访频率并观察治疗效果。结果 12例(20眼)ROP患儿接受雷珠单抗玻璃体内注射治疗,所有眼玻璃体内注射雷珠单抗均有疗效,3例(5眼)出现ROP复发,平均复发时间在治疗后8.8周。1例患儿在双眼注射雷珠单抗后出现单眼复发,所有复发眼接受二次复发时间雷珠单抗玻璃体内注射。末次随访时除1例(2眼)外,其他患眼均达到Ⅲ区血管化。除少量局限的视网膜出血外,未发现与注药治疗相关的局部及全身并发症。结论雷珠单抗玻璃体内注射治疗1型阈值前病变ROP效果明确,可使视网膜血管继续生长,但存在一定的复发率。

Efficacy of intravitreal injection of Ranibizumab for treatment of type 1 prethreshold retinopathy of prematurity

Objective　To observe the efficacy of intravitreal injection of Ranibizumab for treatment of type 1 prethreshold retinopathy of prematurity (ROP).Methods　A retrospective study was performed on type 1 prethreshold ROP patients who received Ranibizumab treatment in Ophthalmology Department of our hospital from April 2016 to August 2017. All of them were treated with intravitreal injection of 0.25 mg/0.025 mL Ranibizumab with in 72 hours after diagnosis. Follow-up examinations were performed at 2 day, 1 week and 2 weeks after treatment and then determined by the patient’s condition. Results　 Twelve ROP patients (20 eyes) received intravitreal injection of Ranibizumab. The treatment was effective for all eyes. However, ROP re-occurred in 3 patients (5 eyes) on average 8.8 weeks after treatment. One patient had unilateral recurrence of ROP after bilateral injection of Ranibizumab. All recurrent eyes required a second intravitreal injection of Ranibizumab. With one (2 eyes) exception, all the other affected eyes exhibited Zone Ⅲ vascularization. There was no local or systemic complications associated with injection treatment except minor localized retinal hemorrhage. Conclusion　Intravitreal injection of Ranibizumab is effective for type 1 prethreshold ROP, and still with growth of retinal blood vessels, but there is a certain recurrence rate.