背景:早已经报道了牵牛花盘异常(MGDA)与持续性增生性原发性玻璃体(PHPV)的关联。早产儿视网膜病变(ROP)如具有视盘异常的早产儿的视网膜病变也已发表。就MGDA的存在而言,我们的案例是独一无二的,PHPV,出生体重正常的足月婴儿的单侧ROP样视网膜病变。
方法:一个5个月大的女孩,足月出生时出生体重为3750克,表现为前PHPV,MGDA和ROP样视网膜病变。为了防止视网膜脱离,她在左眼视盘挖孔边缘接受了360度弹幕激光光凝。在一个月后的随访中,在她的左眼底发现了激光疤痕,没有其他并发症。
结论:PHPV和MGDA在足月和体重正常的婴儿中很少见有ROP样视网膜病变。视网膜周边无血管区,由缺损的视盘的拖动引起的,出生后可能更容易受到氧气变化的影响,导致ROP样视网膜病变。对氧气的高度敏感性会导致一系列变化,例如VEGF和IGF-1的上调可能导致ROP样视网膜病变。
BACKGROUND: Association of morning glory disc anomaly (MGDA) with persistent hyperplastic primary vitreous (
PHPV) has been reported earlier. Retinopathy of prematurity (ROP) like retinopathy in preterm babies with optic disc anomalies has also been published. Our case is unique in terms of presence MGDA,
PHPV, unilateral ROP like retinopathy in a term infant with normal birth weight.
METHODS: A 5-month-old girl, born at term with a birth weight of 3750 g, presented with anterior
PHPV, MGDA and ROP like retinopathy. In order to prevent retinal detachment, she received 360 degree barrage laser photocoagulation at the edge of the optic disc excavation of the left eye. In the follow-up a month later, laser scars were found in her left fundus without other complications.
CONCLUSIONS: PHPV and MGDA with ROP like retinopathy in term and normal weight baby is rare. The peripheral avascular retinal area, caused by the dragging of the defected optic disc, might have been more vulnerable to the oxygen change after birth which resulted in ROP like retinopathy. High sensitivity to oxygen results in a series of changes such as upregulation of VEGF and IGF-1 may cause ROP-like retinopathy.