The efficacy of laser photocoagulation and intravitreal ranibizumab treatment of retinopathy of premature_Chinese Journal of Ocular Fundus Diseases

Authors：

 SunXiantao , SunShuang , WangHui , 卢跃兵 , 夏天 , 陈敏 , 李萍 , 刘梅 , 楚瑞雪 , 蒋瑜 , 赵珂 , 黄方 , 李冠峰 , 周玉

Department of Ophthalmology, Children's Hospital of Zhengzhou, Zhengzhou 450053, China;

Corresponding author：

SunXiantao, Email: sunxt38019896@163.com

Keywords：

Retinopathy of prematurity/therapy; Angiogenesis inhibitors/therapeutic use; Antibodies; monoclonal/therapeutic use; Laser coagulation

DOI：

10.3760/cma.j.issn.1005-1015.2015.01.005

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Objective To investigate the efficacy of laser photocoagulation and intravitreal ranibizumab treatment of retinopathy of premature(ROP). Methods This study included 49 ROP infants (96 eyes), including type 1 pre-threshold ROP (7 infants, 14 eyes), threshold ROP (38 infants, 44 eyes) and aggressive posterior ROP (AP-ROP, 4 infants, 8 eyes). According to the treatments received, all patients were divided into laser photocoagulation (LP) group (40 infants, 78 eyes) and intravitreal ranibizumab (IVR) treatment group (9 infants, 18 eyes). Generally, zoneⅡand stage 3 ROP with clear refractive media received laser photocoagulation, zoneⅠROP and AP-ROP, or eyes with unclear refractive media or infants with poor general condition received IVR. The infant gestational age, birth weight, corrected gestational age at first treatment and the cure rate of the first treatment were analyzed between the two groups, and between three disease types (type 1 pre-threshold, threshold and AP-ROP). Results The gestational age and birth weight was no difference between the LP group and IVR group (t=0.827, 1.911; P > 0.05). The corrected gestational age at first treatment of LP group was significantly smaller than that in the IVR group (t=3.041, P < 0.05). In the LP group, 75 of 78 eyes (96.15%) was cured by the first treatment, 3 of 78 eyes (3.85%) progressed to stage 4A after the first treatment and was controlled by vitrectomy. In the IVR group, 8 of 18 eyes (44.44%) was cured by the first treatment, 10 of 18 eyes (55.56%) progressed to next stage after the first treatment and was controlled by additional laser photocoagulation or repeated IVR. The gestational age and birth weight was no difference between type 1 pre-threshold, threshold and AP-ROP infants (t=2.071, 0.664; P > 0.05). The corrected gestational age at first treatment of type 1 pre-threshold infants was the same of the threshold lesion infants (t=2.054, P > 0.05). The corrected gestational age at first treatment of AP-ROP infants was significantly smaller than that of type 1 pre-threshold and threshold lesion infants (t=3.250, P < 0.05). The cure rate was statistically significant (χ²=24.787, P < 0.05) between there three ROP lesions. Conclusion IVR treatment is suitable for zoneⅠlesions, AP-ROP and Plus lesions, while laser photocoagulation is appropriate for zoneⅡlesions with fibrosis and less vascular proliferation.

Citation： SunXiantao, SunShuang, WangHui. The efficacy of laser photocoagulation and intravitreal ranibizumab treatment of retinopathy of premature. Chinese Journal of Ocular Fundus Diseases, 2015, 31(1): 14-17. doi: 10.3760/cma.j.issn.1005-1015.2015.01.005 Copy

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11.	Chen J, Smith LE.Retinopathy of prematurity[J].Angingenesis, 2007, 10(2):133-140.
12.	Smith LE.Pathogenesis of retinopathy of prematurity[J].Growth Horm IGF Res, 2004, 14(Suppl A):S140-144.

1. 赵培泉, 费萍.早产儿视网膜病变诊断治疗研究现状、问题及展望[J].中华眼底病杂志, 2012, 28(1):3-7.
2. Early Treatment For Retinopathy of Prematurity Cooperative Group.Revised indications for the treatment of retinopathy of prematurity:results of the early treatment for retinopathy of prematurity randomized trial[J].Arch Ophthalmol, 2003, 121(12):1684-1694.
3. 黎晓新, 陈宜.积极推动早产儿视网膜病变的防治[J].中华眼底病杂志, 2008, 24(1):1-4.
4. 陈长征.早产儿视网膜病变诊治新进展[J].中国实用眼科杂志, 2011, 29(5):429-430.
5. 黄欣, 单海冬, 常青, 等.急进性后部型早产儿视网膜病变的临床特征及治疗[J].中华眼底病杂志, 2012, 28(1):33-36.
6. 吴本清, 张国明, 唐松, 等.深圳市早产儿视网膜病变激光光凝治疗效果观察及围手术期管理模式探讨[J].中华眼底病杂志, 2010, 28(3):271-272.
7. 尹虹, 黎晓新, 梁建宏, 等.激光光凝及抗血管内皮生长因子单克隆抗体bevacizumab玻璃体腔注射治疗早产儿视网膜病变的疗效观察[J].中华眼底病杂志, 2012, 28(1):15-17.
8. 张国明, 唐松, 曾键, 等.早产儿视网膜病变激光光凝辅助玻璃体腔注射抗血管内皮生长因子单克隆抗体bevacizumab治疗临床疗效观察[J].中华眼底病杂志, 2012, 28(1):18-21.
9. 李家恺, 赵培泉.贝伐单抗在早产儿视网膜病变治疗中的应用[J].国际眼科纵览, 2010, 34(4):234-237.
10. 黎晓新.眼内抗血管生成药物临床应用的利与弊[J].中华眼科杂志, 2012, 48(10):870-873.
11. Chen J, Smith LE.Retinopathy of prematurity[J].Angingenesis, 2007, 10(2):133-140.
12. Smith LE.Pathogenesis of retinopathy of prematurity[J].Growth Horm IGF Res, 2004, 14(Suppl A):S140-144.

Chinese Journal of Ocular Fundus Diseases

The efficacy of laser photocoagulation and intravitreal ranibizumab treatment of retinopathy of premature

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