康柏西普治疗早产儿视网膜病变患儿屈光状态改变的临床研究

doi:10.3760/cma.j.cn115909-20210927-00398

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Abstract Objective: To study the changes in the refractive status of children with retinopathy of prematurity (ROP) after intravitreal injection of combercept, and to explore the relationship between refractive status and the number of injections, gestational weeks, birth weight, axial length and retinal vascularization zone. Methods: In this prospective clinical study, infants diagnosed with type 2 ROP pre-threshold disease in Weifang Eye Hospital from April 2017 to June 2021 were recruited. All infants underwent high myopia gene detection. Finally, 127 eyes of 64 cases were included in this study. According to the severity of the disease, Intravitreal conbercept (IVC) treatment was performed on demand, and the treatment times were divided into 3 groups, 22 cases (43 eyes) of infants were included in group A (0 injection), 30 cases (53 eyes) of infants were included in group B (1 injection) and 18 cases (31 eyes) of infants were included in group C (2 injection). When the corrected gestational age was 3, 6 and 12 months, the refractive state changes were observed, and the spherical equivalent (SE), astigmatism, axial length and retinal vascularization zone were recorded. The refractive status of the three groups with different corrected gestational ages was compared to understand the relationship between refractive status and the number of injections, gestational weeks, birth weight, axial length and retinal vascularization zone. One-way ANOVA analysis of variance was used for the comparison of the SE in the three groups. The Kruskal-Wallis test was used for comparison of astigmatism. Pearson correlation analysis was used for data analysis on the correlation between equivalent spherical errors and the development of the ocular axis and the retinal vascularization zone. Results: At the corrected gestational age of 3 months and 6 months, there was no significant difference in SE and astigmatism among the three groups. At the corrected gestational age of 12 months, the average SE and astigmatism of groups A, B and C were statistically significant (F=6.59, P=0.002; H=7.39, P=0.025). Further comparison after ANOVA showed that the average SE difference between group A and group B and group A and group C was statistically significant (P=0.006; P=0.007). The difference in astigmatism between groups A and C was statistically significant (P=0.020). At the corrected gestational age of 12 months, there was no significant difference in the incidence of refractive error and myopia rate among the three groups. However, the incidence of astigmatism was statistically significant (χ2 =8.96, P=0.011). Further pairwise comparisons showed that the differences between group A and group C, group B and group C were statistically significant (χ2 =7.08, P=0.008; χ2 =6.82, P=0.009). At the corrected gestational age of 3 months, SE was related to gestational age (r=-0.18, P=0.043), birth weight (r=-0.19, P=0.032), and axial length (r=-0.26, P=0.003). The retinal vascular divisions (r=- 0.20, P=0.023) were all negatively correlated. When the corrected ages were 6 months and 12 months, SE was negatively correlated with axial length (r=-0.30, P=0.001). Conclusions: At the corrected gestational age of 12 months, the hyperopia reserve of children with ROP after IVC treatment is lower than that of children with spontaneous regression of ROP. Repeated injection has no significant effect on the short-term refractive status of children with ROP.

Key words： retinopathy of prematuriry refractive status myopia astigmatism conbercept anti-vascular endothelial growth factor

Received: 27 September 2021

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Fund:The Natural Science Foundation of Shandong (ZR2021MH411); Bethune Langmu Young and Middle-aged Eye Research Foundation (BJ-LM2019005J); Science Research Program Project Foundation of Weifang (2021RKX104)

Corresponding Authors: Jie Zhang, Weifang Eye Hospital, Department of Ophthalmology, Weifang 261000, China (Email: zhangjie9jiezuo@126.com)

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Hongyun Ran,Jiantao Ren,Shuchan Li等. Clinical Study of Conbercept in the Treatment of Refractive Status Changes in Infants with Retinopathy of Prematurity[J]. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(4): 298-303.

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20210927-00398 OR https://www.cjoovs.com/EN/Y2022/V24/I4/298

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