[1]傅征,杨晖,洪志斌,等.玻璃体内注射康柏西普治疗急进性后极部早产儿视网膜病变早期眼压的改变[J].眼科新进展,2021,41(1):062-65.[doi:10.13389/j.cnki.rao.2021.0013]
 FU Zheng,YANG Hui,HONG Zhibin,et al.Intraocular pressure changes in early stage of aggressive posterior retinopathy of prematurity treated by vitreous injection of conbercept[J].Recent Advances in Ophthalmology,2021,41(1):062-65.[doi:10.13389/j.cnki.rao.2021.0013]
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玻璃体内注射康柏西普治疗急进性后极部早产儿视网膜病变早期眼压的改变/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年1期
页码:
062-65
栏目:
应用研究
出版日期:
2021-01-05

文章信息/Info

Title:
Intraocular pressure changes in early stage of aggressive posterior retinopathy of prematurity treated by vitreous injection of conbercept
作者:
傅征杨晖洪志斌尹雪熊薇薇王娜
361000 福建省厦门市,厦门市儿童医院眼科
Author(s):
FU ZhengYANG HuiHONG ZhibinYIN XueXIONG WeiweiWANG Na
Department of Ophthalmology,Xiamen Children’s Hospital,Xiamen 361000,Fujian Province,China
关键词:
急进性后极部早产儿视网膜病变玻璃体内注射康柏西普眼压虹膜新生血管
Keywords:
aggressive posterior retinopathy of prematurity conbercept intraocular pressure iris neovascularization low birth-weight infant
分类号:
R779.7
DOI:
10.13389/j.cnki.rao.2021.0013
文献标志码:
A
摘要:
目的 探讨玻璃体内注射康柏西普治疗急进性后极部早产儿视网膜病变(AP-ROP)患儿早期眼压的改变。方法 选取2017年6月至2019年5月于厦门市儿童医院确诊的AP-ROP行玻璃体内注射康柏西普(0.25 mg/0.025 mL)治疗的22例(32眼)患儿纳入研究。分别记录注射前5 min及注射后1 min、5 min、10 min、2 h、24 h眼压,同时记录注射后疗效并分析并发症情况。结果 22例(32眼)患儿注射前5 min眼压为(10.44±2.68)mmHg(1 kPa=7.5 mmHg),注射后1 min、5 min、10 min、2 h及24 h的眼压分别为(18.66±3.09)mmHg、(21.81±3.09)mmHg、(18.34±3.26)mmHg、(14.53±3.29)mmHg、(12.03±3.36)mmHg。方差分析结果显示,不同时间点间的眼压差异具有统计学意义(F=61.91,P<0.01);两两时间点比较结果显示,注射后10 min与注射后1 min、注射后24 h与注射前5 min眼压相比差异均无统计学意义(均为P>0.05),其余各观察时间点间眼压两两相比差异均有统计学意义(均为P<0.05)。注射后各时间点眼压的变化趋势为先升后降,眼压峰值出现在注射后5 min。患儿注射后5 min眼压较注射前升高幅度≥15 mmHg的患眼,其合并虹膜新生血管的比例更高,出生体质量更低(均为P<0.05)。结论 玻璃体内注射康柏西普治疗AP-ROP患儿出现的眼压升高是一过性的,眼科临床医生需多关注注射后5 min的眼压,以避免因为眼压升高影响术后效果。
Abstract:
Objective To investigate changes in intraocular pressure (IOP) after intravitreal conbercept (IVC) administration to infants with aggressive posterior retinopathy of prematurity (AP-ROP).Methods Retrospective analysis. From June 2017 to May 2019, 22 patients (32 eyes) of AP-ROP diagnosed in Xiamen Children’s Hospital who received intravitreal injection of conbercept (0.25 mg/0.025 mL) were included in the study. IOP was measured and recorded at 5 minutes before operation, 1 minute, 5 minutes, 10 minutes, 2 hours and 24 hours after operation.Results The IOP of 32 eyes of children was (10.44±2.68) mmHg (1 kPa=7.5 mmHg) at 5 min before injection, and (18.66±3.09)mmHg, (21.81±3.09)mmHg, (18.34±3.26)mmHg, (14.53±3.29)mmHg, (12.03±3.36)mmHg at 1 minute, 5 minutes, 10 minutes, 2 hours and 24 hours after injection. The results of analysis of variance showed that the difference in IOP between different time points was statistically significant (F=61.91, P<0.01). The comparison between the two time points showed that there were no significant differences in IOP between 10 minutes and 1 minute after injection, 24 hours after injection and 5 minute before injection (both P>0.05), while there were statistically significant differences in the pairwise comparison between the other time points (all P<0.05). The change trend of IOP in each time period was firstly increased and then decreased, and the peak IOP was 5 minutes after injection. Children whose IOP increased by ≥15 mmHg 5 minutes after injection had a higher proportion of combined iris neovascularization and lower birth weight (both P<0.05).Conclusion In the treatment of AP-ROP by intravitreal injection of conbercept, the elevated IOP is non fluctuating and transient. Ophthalmologists should pay more attention to IOP (5 minutes after operation) to avoid the influence of elevated IOP on postoperative efficacy.

参考文献/References:

[1] 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 randomaized trial [J].Arch Ophthalmol,2003,121(12):1684-1694.
[2] 王宇,周晓光,陈志均.早产儿视网膜病治疗研究进展[J].中华实用儿科临床杂志,2017,32(2):146-148.
WANG Y,ZHOU X G,CHEN Z J.Advances in treatment of retinopathy of prematurity[J].Chin J Appl Clin Pediatr,2017,32(2):146-148.
[3] KOURLAS H,ABRAMS P.Ranibizumab for the treatment of neovascular age-related macular degeneration:a review[J].Clin Ther,2007,29(9):1850-1861.
[4] ROSENFELD P J,BROWN D M,HEIER J S,BOYER D S,KAISER P K,CHUNG C Y,et al.Ranibizumab for neovascular age-related macular degeneration [J].N Engl J Med,2006,355(14):1419-1431.
[5] GISMONDI M,SALATI C,SALVETAT M L,MARCO Z,PAOLO B.Short-term effect of intravitreal injection of Ranibizumab (Lucentis) on intraocular pressure[J].J Glaucoma,2009,18(9):658-661.
[6] MINTZ-HITTNER H A,KENNEDY K A.Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity[J].N Eng J Med,2011,364(7):603-615.
[7] 程湧,梁建宏,黎晓新.康柏西普玻璃体内注射治疗急进性后极部早产儿视网膜病变的疗效观察[J].中华眼底病杂志,2017,33(2):144-147.
CHENG Y,LIANG J H,LI X X.Intravitreal injection of conbercept for aggressive posterior retinopathy of prematurity[J].Chin J Ocul Fundus Dis,2017,33(2):144-147.
[8] BAI Y C,NIE H J,WEI S Y,LU X H,KE X Y,OUYANG X J,et al.Efficacy of intravitreal conbercept injection in the treatment of retinopathy of prematurity[J].Br J Ophthalmol,2019,103(4):494-498.
[9] MOJICA G,HARIPRASAD S M,JAGER R D,MIELER W F.Short-term intraocular pressure trends following intravitreal infections of ranibizumab(Lucentis)for the treatment of wet age-related macular degeneration[J].Br J Ophthalmol,2008,92(4):584.
[10] HOSSEINI H,KHALILI M R,NOWROOZIZADEH S.Intravitreal injection of bevacizumab(Avastin) for treatment of stage 3 retinopathy of prematurity in zone I or posterior zone II[J].Retina,2009,29(4):562.
[11] 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.
LI X X.Intraocular antiangiogenic drugs in clinical application advantages and disadvantages[J].Chin J Ophthalmol,2012,48(10):870-873.
[12] MICHELSON G,GROH M J,LANGHANS M.Perfusion of the juxtapapillary retina and optic nerve head in acute ocular hypertension[J].German J Ophthalmol,1996,5(6):315-321.
[13] YAN D B,COLOMA F M,METHEETRAIRUT A,TROPE G E,HEATHCOTE J G,ETHIER C R.Deformation of the lamina cribrosa by elevated intraocular pressure[J].Br J Ophthalmol,1994,78(8):643-648.
[14] KATO A,OKAMOTO Y,OKAMOTO F,SAITO M,MIYAZONO Y,OSHIKA T.Short-term intraocular pressure changes after intravitreal injection of bevacizumab for retinopathy of prematurity[J].Jpn J Ophthalmol,2019,63(3):262-268.
[15] BUI B V,BATCHA A H,FLETCHER E,WONG V H,FORTUNE B.Relationship between the magnitude of intraocular pressure during an episode of acute elevation and retinal damage four weeks later in rats[J].PLoS One,2013,8(7):e70513.
[16] SATOR-KATZENSCHLAGER S M,OEHMKE M J,DEUSCH E,DOLEZAL S,HEINZE G,WEDRICH A.Effects of remifentanil and fentanyl on intraocular pressure during the maitenance and recovery of anaesthesia in patients undergoing non-ophthalmic surgery[J].Eur J Anaesthesiol,2004,21(2):95-100.
[17] 张晓光,杨宏万,陈君毅.七氟烷吸入麻醉对大鼠青光眼造模眼眼压的影响[J].中国眼耳鼻喉科杂志,2012,12(4):205-208.
ZHANG X G,YANG H W,CHEN J Y.Effects of sevoflurane on intraocular pressure in elevated intraocular pressure rat model[J].Chin J Ophthalmol Otorhinolaryngol,2012,12(4):205-208.
[18] KOTLIAR K,MAIER M,BAUER S,FEUCHT N,LOHMANN C,LANZ I.Effect of intravitreal infections and volume changes on intraocular pressure:clinical results and biomechanical model[J].Acta Ophthalmol Scand,2007,85(7):777-781.
[19] 崔尘,陈辉,朱蓉嵘.雷珠单抗治疗视网膜静脉阻塞继发黄斑水肿对眼压的影响[J].交通医学,2015,29(2):154-156.
CUI C,CHEN H,ZHU R R.Effect of ranibizumab on intraocular pressure in the treatment of macular edema secondary to retinal vein occlusion[J].Med J Commun,2015,29(2):154-156.
[20] KIM J E,MANTRAVADI A V,HUR E Y,COVERT D J.Short-term intraocular pressure changes immediately after intravitreal injections of anti-vascular endothelial growth factor agents[J].Am J Ophthalmol,2008,146(6):930-934.
[21] HOERSTER R,MUETHER P,DAHLKE C,MEHLER K,OVERTHUR A,KIRCHHOF B,et al.Serum concentrations of vascular endothelial growth factor in an infant treated with ranibizumab for retinopathy of prematurity[J].Acta Ophthalmol,2013,91(1):e74-75.
[22] ZHOU Y,JIANG Y R,BAI Y J,WEN J,CHEN L.Vascular endothelial growth factor plasma levels before and after treatment of retinopathy of prematurity with ranibizumab [J].Graefes Arch Clin Exp Ophthalmol,2016,254(1):31-36.
[23] SAHIN A,TURKCU F M,OZKURT Z G.A lower dose of intravitreal bevacizumab effectively treats retinopathy of prematurity[J].J AAPOS,2018,22(1):83.
[24] CONNOR A J,PAPASTAVROU V T,HILLIER R J,SHAFIQ A.Ultra-low dose intravitreal bevacizumab for the treatment of retinopathy of prematurity[J].J Pediatr Ophthalmol Strabismus,2015,52(Online):e20-21.
[25] CHENG Y,MENG Q Y,LINGHU D D,ZHAO M W,LIANG J H.A lower dose of intravitreal conbercept effectively treats retinopathy of prematurity[J].Sci Rep,2018,8:10732.

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备注/Memo

备注/Memo:
厦门市科技局惠民项目(编号:3502Z20189046)
更新日期/Last Update: 2021-01-05