PDF(Pubmed)
Abstract：
This study aimed to determine whether the state of retinal vascularization after anti-vascular endothelial growth factor (anti-VEGF) injection can help predict the risk of reactivated retinopathy of prematurity (ROP) requiring treatment and whether repeated ranibizumab injection will be effective in such cases. We retrospectively reviewed 24 infants (43 eyes) who received ranibizumab monotherapy between January 2021 and December 2022. All eyes were classified as having non-retreated ROP or retreated ROP. The state of ROP at the time of treatment, the time required for resolution of plus disease, and the extent of vascularization at 4 and 8 weeks after treatment were analyzed. Extent of temporal retinal vascularization was measured with serial fundus images using disc-fovea distance (DF) unit and disc diameter (DD). Reactivated ROP requiring treatment occurred in six infants (25.0%) and ten eyes (23.3%) after ranibizumab treatment. The mean retreatment interval was 9.0 ± 3.3 weeks (range 4-16). In the retreated ROP group, the time required for the resolution of plus disease after primary injection was longer compared to the control group (13.3 days vs 5.2 days), with a mean ROP regression time of 3.4 weeks. All eyes in the retreated ROP showed retinal vascularization < 0.5 DF from the original site at 4 weeks after injection. In 90% of cases with retreated ROP, the extent of vascularization at 8 weeks after injection was within 1 DF from the original ROP site, and all cases showed reactivation in the posterior Zone II area. The extent of retinal neovascularization in the retreated group was an average of 0.7 DD (vs 1.7 DD) and 1.3 DD (vs 3.3 DD) at 4 and 8 weeks after injection, respectively. After ranibizumab retreatment, only one reactivated case with vitreous traction progressed to focal retinal detachment, while all other cases regressed with peripheral vascular development. The continuation of delayed retinal blood vessel development after ≥ 8 weeks may indicate a high likelihood of reactivated ROP requiring treatment. In the absence of vitreous traction, ranibizumab reinjection is likely to be effective in treating reactivated ROP requiring treatment.
摘要：
这项研究旨在确定抗血管内皮生长因子（抗VEGF）注射后的视网膜血管形成状态是否可以帮助预测需要治疗的早产儿视网膜病变（ROP）的风险，以及重复雷珠单抗注射在这种情况下是否有效。我们回顾性分析了2021年1月至2022年12月期间接受雷珠单抗单药治疗的24名婴儿（43只眼）。所有眼睛被分类为具有未再治疗的ROP或再治疗的ROP。治疗时ROP的状态，解决+疾病所需的时间，并分析治疗后4周和8周的血管化程度。使用盘-中央凹距离（DF）单位和盘直径（DD）通过连续眼底图像测量颞侧视网膜血管形成的程度。雷珠单抗治疗后，6名婴儿（25.0％）和10只眼睛（23.3％）发生了需要治疗的重新激活的ROP。平均再治疗间隔为9.0±3.3周（范围4-16）。在后退的ROP组中，与对照组相比，初次注射后疾病消退所需的时间更长（13.3天比5.2天），平均ROP回归时间为3.4周。在注射后4周,在再治疗的ROP中的所有眼睛显示与原始部位的视网膜血管形成<0.5DF。在90％的ROP患者中，注射后8周的血管化程度与原始ROP部位相差1DF以内，所有病例均在后II区重新激活。注射后4周和8周，再治疗组视网膜新生血管的程度平均为0.7DD（vs1.7DD）和1.3DD（vs3.3DD）。分别。雷珠单抗复治后,只有一例玻璃体牵引再激活病例进展为局灶性视网膜脱离,而所有其他病例均随外周血管发育消退。≥8周后视网膜血管发育延迟的持续可能表明需要治疗的ROP重新激活的可能性很高。在没有玻璃体牵引的情况下，再注射雷珠单抗可能对需要治疗的再激活ROP有效.
