玻璃体内注射雷珠单抗治疗新生儿家族性渗出性玻璃体视网膜病变 2 期的临床疗效研究

南 李(潍坊眼科医院，中国)
海涛 韩(潍坊眼科医院，中国)

摘要

目的：观察玻璃体腔内注射雷珠单抗（IVR）对治疗新生儿（＜28天）家族性渗出性玻璃体视网膜病变（Familial Exudative Vitreoretinopathy，FEVR）2期的临床疗效及安全性。方法：回顾性分析我院2017年1月至2018年7月确诊为FEVR2期病变的14例新生儿患者（27只眼）在局麻下行玻璃体内注射雷珠单抗0.025mL（10mg/mL）后视网膜新生血管的消退情况及安全性。结果：患儿的平均孕龄、出生体重、矫正胎龄及随访时间分别为：39.34±0.95周、3.36±0.32周、41.30±1.45周、62.31±6.20周。27只眼中，经单次IVR治疗后新生血管完全消退24只眼，占所有患眼的88.89%；重复IVR或者激光治疗3只眼，占所有患眼的11.11%，其中1只眼再次IVR后病情恢复稳定，占全部患眼的3.70%，2只眼在重复IVR后，病变处仍出现新生血管及纤维增殖，占全部患眼的7.41%，对其进行激光光凝治疗后，患者病情恢复稳定；所有患眼在治疗后均未见与药物或治疗方式相关的眼部并发症的发生。结论：雷珠单抗对FEVR2期病变的治疗有效，且通过Retcam筛查婴幼儿FEVR是早期发现及治疗FEVR的关键，其长期的疗效及安全性还需要进一步研究。

关键词

家族性渗出性玻璃体视网膜病变；雷珠单抗；新生血管消退

参考

M, Madison, Slusher, et al. Familial Exudative Vitreoretinopathy[J].American Journal of Ophthalmology,1979,87(2):152-156.

Geloneck M M, Chuang A Z, Clark W L,et al. Refractive

Outcomes Following Bevacizumab Monotherapy Compared With

Conventional Laser Treatment A Randomized Clinical Trial[J].

Jama Ophthalmology,2014,132(11):1327-1333.

彭晓燕,张风,孟淑敏,等.视网膜冷凝治疗Coats病的临床效观察[J].中华眼底病志,2005,21(3):187-188.

Sanghi G, Dogra M R, Das P,et al. Aggressive posterior retinopathy of prematurity in Asian Indian babies: spectrum of disease and outcome after laser treatment[J].Retina,2009,29(9):1335.

Tarkkanen A.Coat’s disease: clinical, angiographic,

histopathological findings and clinical management[J]. The British journal of ophthal mology, 1983,67(11):766-776.

Tagami M, Kusuhara S, Honda S, et al. Rapid regression of retinal hemorrhage and neovascularization in a case of familial exudative vitreoretinopathy treated with intravitreal bevacizumab[J].Graefes Arch Clin Exp Ophthalmol,2008,246(12):1787-1789.

Henry C R, Sisk R A, Tzu J H, et al. Long-term follow-up of

intravitreal bevacizumab for the treatment of pediatric retinal and choroidal diseases[J].Journal of American Association for Pediatric Ophthalmology and Strabismus,2015.

Pendergast SD. Familial exudative vitreoretinopathy Results of surgical management[J].Ophth almology,1998,105(6):1015-1023.

Lu YZ, Deng GD, Liu JH, et al.The role of intravitreal ranubizumab in the treatment of familial exudative vitreoretinopathy of stage 2 or greater.Int[J].Ophthalmol,2018,11(6):976-980.

Trese MT. Capone A Jr. Familial exudative vitreoretinopathy[J].In:Hartenett ME, ed. Pediatric retina. Philadelphia: Lippincott williams & wilkins,2005:425-428.

Dickinson JL, Sale MM, Passmore A, et al. Mutations in the

NDP gene: contribution to Norrie disease, familial exudative

vitreoretinopathy and retinopathy of prematurity[J].Clinical &

experimental ophthalm ology,2006,34(7):682-688.

Xu Q,Wang Y,Dabdoub A,et al.Vascular development in the retina and inner ear: control by Norrin and Frizzled-4, a high-affinity ligand-receptor pair[J].Cell,2004,116(6):883-895.

Zhao S, Overbeek PA. Elevated TGF beta signalling inhibited ocular vascular development[J].Dev Biol,2001,237:45-53.

Connor TB, Roberts AB, Sporn MB, et al. Correlation of fibrosis and transforming growth factor -beta type 2 levels in the eye[J].The Journal of clinical investigation,1989,83(5):16 61-1666.

Treatment of retinopathy of prematurity with vascular

endothelial growth factor inhibitors[J].Early human developme

nt,2012,88(12):937-941.

DOI: http://dx.doi.org/10.12345/yzlcyxzz.v6i6.13079