PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to evaluate the treatment efficacy, anatomical outcomes, and refractive outcomes of laser photocoagulation (LPC) and intravitreal ranibizumab (IVR) in the treatment of type I retinopathy of prematurity (ROP) at one-year follow-up.
METHODS: This is a retrospective study on the treatment of type I ROP and aggressive ROP (A-ROP) using LPC or IVR in three Malaysian hospitals providing pediatric ophthalmology services from January 2019 to December 2021. Information on gestational age, birth weight, ROP zone and stage, and underlying comorbidities was collected. Parameters for evaluating treatment efficacy include the time taken to achieve complete regression, the regression rate, and the reactivation rate. The anatomical and refractive outcomes were evaluated at one year of adjusted age.
RESULTS: This study included 92 eyes from 46 infants. Of these, 42 eyes received LPC as the initial treatment, while 50 eyes underwent IVR. A higher percentage of infants with cardiovascular disease were treated with IVR (66.7%) compared to LPC (40%) (p<0.05). However, there were no significant differences in gestational age, birth weight, respiratory distress syndrome, sepsis, or intraventricular hemorrhage between the two treatment groups (p>0.05). Infants treated with LPC had a higher regression rate than those treated with IVR, but they were also significantly more myopic and had worse best-corrected visual acuity (BCVA). Conversely, infants treated with IVR experienced a significantly higher reactivation rate compared to those treated with LPC. Logistic regression analysis showed no significant associations between gestational age, birth weight, plus disease, zone 1 ROP, and the choice of initial treatment with the reactivation of ROP.
CONCLUSIONS: Both LPC and IVR effectively treat type I ROP in infants, with IVR yielding superior anatomical and refractive outcomes and LPC offering a lower reactivation rate. Understanding individual patient characteristics is crucial for treatment selection.
METHODS: This is a retrospective study on the treatment of type I ROP and aggressive ROP (A-ROP) using LPC or IVR in three Malaysian hospitals providing pediatric ophthalmology services from January 2019 to December 2021. Information on gestational age, birth weight, ROP zone and stage, and underlying comorbidities was collected. Parameters for evaluating treatment efficacy include the time taken to achieve complete regression, the regression rate, and the reactivation rate. The anatomical and refractive outcomes were evaluated at one year of adjusted age.
RESULTS: This study included 92 eyes from 46 infants. Of these, 42 eyes received LPC as the initial treatment, while 50 eyes underwent IVR. A higher percentage of infants with cardiovascular disease were treated with IVR (66.7%) compared to LPC (40%) (p<0.05). However, there were no significant differences in gestational age, birth weight, respiratory distress syndrome, sepsis, or intraventricular hemorrhage between the two treatment groups (p>0.05). Infants treated with LPC had a higher regression rate than those treated with IVR, but they were also significantly more myopic and had worse best-corrected visual acuity (BCVA). Conversely, infants treated with IVR experienced a significantly higher reactivation rate compared to those treated with LPC. Logistic regression analysis showed no significant associations between gestational age, birth weight, plus disease, zone 1 ROP, and the choice of initial treatment with the reactivation of ROP.
CONCLUSIONS: Both LPC and IVR effectively treat type I ROP in infants, with IVR yielding superior anatomical and refractive outcomes and LPC offering a lower reactivation rate. Understanding individual patient characteristics is crucial for treatment selection.
摘要：
目的：本研究旨在评估治疗效果，解剖学结果，1年随访时,激光光凝(LPC)和玻璃体腔注射雷珠单抗(IVR)治疗I型早产儿视网膜病变(ROP)的屈光结果.
方法：这是一项回顾性研究，研究了2019年1月至2021年12月在马来西亚三家提供儿科眼科服务的医院使用LPC或IVR治疗I型ROP和侵袭性ROP（A-ROP）。有关胎龄的信息，出生体重,ROP区和阶段，并收集了潜在的合并症。评估疗效的参数包括达到完全消退所需的时间。回归率，和再激活率。在调整年龄1岁时评估解剖学和屈光结果。
结果：这项研究包括46名婴儿的92只眼。其中,42只眼睛接受LPC作为初始治疗，而50只眼睛接受了IVR。与LPC（40％）相比，IVR治疗的心血管疾病婴儿比例更高（66.7％）（p<0.05）。然而,胎龄没有显著差异,出生体重,呼吸窘迫综合征,脓毒症,或脑室内出血在两个治疗组之间（p>0.05）。用LPC治疗的婴儿比IVR治疗的婴儿有更高的消退率，但他们的近视程度也明显更高,最佳矫正视力(BCVA)较差.相反，与接受LPC治疗的婴儿相比,接受IVR治疗的婴儿的再激活率明显更高.Logistic回归分析显示,胎龄与胎龄之间无显著关联,出生体重,加上疾病，1区ROP,以及ROP再激活时初始治疗的选择。
结论：LPC和IVR均可有效治疗婴儿I型ROP，IVR产生优越的解剖和屈光结果，LPC提供较低的再激活率。了解患者的个体特征对于治疗选择至关重要。
方法：这是一项回顾性研究，研究了2019年1月至2021年12月在马来西亚三家提供儿科眼科服务的医院使用LPC或IVR治疗I型ROP和侵袭性ROP（A-ROP）。有关胎龄的信息，出生体重,ROP区和阶段，并收集了潜在的合并症。评估疗效的参数包括达到完全消退所需的时间。回归率，和再激活率。在调整年龄1岁时评估解剖学和屈光结果。
结果：这项研究包括46名婴儿的92只眼。其中,42只眼睛接受LPC作为初始治疗，而50只眼睛接受了IVR。与LPC（40％）相比，IVR治疗的心血管疾病婴儿比例更高（66.7％）（p<0.05）。然而,胎龄没有显著差异,出生体重,呼吸窘迫综合征,脓毒症,或脑室内出血在两个治疗组之间（p>0.05）。用LPC治疗的婴儿比IVR治疗的婴儿有更高的消退率，但他们的近视程度也明显更高,最佳矫正视力(BCVA)较差.相反，与接受LPC治疗的婴儿相比,接受IVR治疗的婴儿的再激活率明显更高.Logistic回归分析显示,胎龄与胎龄之间无显著关联,出生体重,加上疾病，1区ROP,以及ROP再激活时初始治疗的选择。
结论：LPC和IVR均可有效治疗婴儿I型ROP，IVR产生优越的解剖和屈光结果，LPC提供较低的再激活率。了解患者的个体特征对于治疗选择至关重要。
