雷珠单抗治疗早产儿视网膜病变对眼部生物学参数的影响

Effects of Ranibizumab on ocular biological parameters in the treatment of retinopathy of prematurity

摘要:

目的：探讨玻璃体腔注射雷珠单抗治疗早产儿视网膜病变(ROP)对眼部参数的影响，并分析其与出生体质量(BW)和矫正后年龄(PMA)的关系。

方法：选取2016-01-01/2022-01-31于西北妇女儿童医院接受常规ROP筛查的早产儿98例，根据Retcam3眼底筛查结果分为ROP组(49例)和无ROP组(49例)，其中ROP组患儿双眼均行玻璃体腔注射雷珠单抗治疗，平均治疗PMA为38.02±3.03周。两组患儿分别于PMA 0月(40周±14d)、PMA 3月(52周±28d)、PMA 6月(64周±28d)测量眼部参数。

结果：PMA 0月时，ROP组和无ROP组患儿眼轴长度(AL)、前房深度(ACD)、晶状体厚度(LT)、玻璃体长度(VL)和中央角膜厚度(CCT)均无差异(P>0.05)； PMA 3、6月时，ROP组患儿ACD均大于无ROP组，LT均小于无ROP组(P<0.05)； PMA 6月时，ROP组患儿AL、VL均小于无ROP组(P<0.05)。ROP组和无ROP组患儿AL、ACD、VL与PMA呈正相关，CCT与PMA呈负相关； 无ROP组患儿LT与PMA呈正相关； ROP组患儿LT与BW和PMA均无相关性。

结论：玻璃体腔注射雷珠单抗治疗ROP早期(PMA 0～6月)患儿眼部发育较无ROP早产儿慢，BW、PMA是早产儿眼部参数的主要影响因素。

Abstract:

AIM: To investigate the effect of intravitreal ranibizumab injection on ocular parameters in the treatment of retinopathy of prematurity(ROP), and analyze its relationship with birth weight(BW)and postmenstrual age(PMA).

METHODS: A total of 98 premature infants who received routine ROP screening at Northwest Women's and Children's Hospital from January 1, 2016 to January 31, 2022 were selected, and they were divided into ROP group(49 cases)and non-ROP group(49 cases)according to the results of Retcam3 fundus screening. All children in ROP group were treated with intravitreal ranibizumab injection, with an average PMA of 38.02±3.03 weeks. The ocular parameters were measured at the PMA of 0 month(40 weeks±14d), 3 months(52 weeks±28d)and 6 months(64 weeks±28d), respectively.

RESULTS: There was no difference in axial length(AL), anterior chamber depth(ACD), lens thickness(LT), vitreous length(VL)and central corneal thickness(CCT)between ROP group and non-ROP group at the PMA of 0 month(P>0.05); At the PMA of 3 and 6 months, ACD in ROP group was higher than that in non-ROP group, and LT was lower than that in non-ROP group(P<0.05); at the PMA of 6 months, AL and VL in ROP group were lower than those in non-ROP group(P<0.05). AL, ACD and VL were positively correlated with PMA in ROP group and non-ROP group, while CCT was negatively correlated with PMA; there was a positive correlation between LT and PMA in children without ROP. There was no correlation among LT, BW and PMA in ROP group.

CONCLUSION: The ocular development of children with early ROP(PMA 0～6 months)treated by intravitreal ranibizumab injection is slower than that of premature infants without ROP, and BW and PMA are the main influencing factors of ocular parameters of premature infants.