象限分类法在1型阈值前期和阈值期早产儿视网膜病变中的应用

Application of quadrant classification in infants with threshold and type 1 prethreshold stage retinopathy of premature

摘要:

目的：探讨象限分类法在1型阈值前期、阈值期早产儿视网膜病变中的应用。

方法：收集2017-04/2018-01来南昌大学附属眼科医院治疗的1型阈值前期、阈值期早产儿视网膜病变患儿32例进行回顾性病例分析。以象限法将这些早产儿视网膜病变病例中的主要病变位置及范围分为三类：仅分布在一个象限(鼻上、鼻下、颞上、颞下)记录为“1个象限”； 分布在两个象限者(颞上+颞下、鼻上+鼻下、鼻上+颞上、鼻下+颞下、鼻上+颞下、鼻下+颞上)记录为“2个象限”，分布超过两个象限者记录为“>2个象限”。通过象限法来观察这些病例的临床特点以及玻璃体腔注射雷珠单抗治疗后的治愈及复发情况。

结果：纳入研究的32例62眼早产儿视网膜病变患儿中，仅分布在1个象限的有2眼(3%)，单次玻璃体腔注药治愈构成比100%； 分布在2个象限的共25眼(40%)，单次玻璃体腔注药治愈构成比100%； 分布>2个象限的共35眼(56%)，单次玻璃体腔注药治愈构成比74%，复发构成比26%。

结论：1型阈值前期、阈值期早产儿视网膜病变的主要病变部位大多数分布在颞侧上下象限，而且分布的象限数越多，病情越严重，玻璃体腔注射雷珠单抗治疗的复发可能性越高。

Abstract:

AIM: To explore the possible application of quadrant classification in retinopathy of premature infants at threshold and type 1 pre-threshold stage.

METHODS: Thirty-two preterm infants with retinopathy at the threshold and type 1 threshold preterm stage in the Affiliated Eye Hospital of Nanchang University from April 2017 to January 2018 were recruited for retrospective case analysis. The main location and stage of the retinopathy in these premature infants were divided into three categories by the quadrant method: only one quadrant(above the nose, subnasal, supratemporal, and subtemporal)recorded as “1 quadrant”; distributed in two quadrants(supertemporal+infratemporal, supra-nasal+sub-nasal, supra-nasal+super-temporal, sub-nasal+sub-temporal, supra-nasal+sub-temporal, sub-nasal+super-temporal)were recorded as “2 quadrants”; distributed more than two quadrants recorded as “>2 quadrants”. The clinic characteristics of all cases and the responses to intravitreal injection of ranibizumab were observed according to the quadrant method.

RESULTS: Totally 32 cases with 62 eyes of premature infants recruited in the study. Only 2 eyes were in 1 quadrant before surgery, and the efficiency of a single injection was 100%. A total of 25 eyes were distributed in 2 quadrants, and with a single injection, the effective rate was 100%. 35 eyes with a distribution “2 quadrants” had a single injection rate of only 74% and a recurrence rate of 26%.

CONCLUSION: The main lesions in most cases are distributed in “2 quadrants”(supertemporal+subtemporal). The more of quadrants accumulated for the major lesions and the more severe of the condition; the higher recurrence rate after intravitreous anti-VEGF therapy.