Retinal detachment of regressed retinopathy of prematurity in children aged 2 to 15 years
Retinal detachment of regressed retinopathy of prematurity in children aged 2 to 15 years
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DOI：
10.1097/00006982-200406000-00006
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发表时间：
2004-06-01
影响因子：
3.3
通讯作者：
Chung, H
中科院分区：
文献类型：
--
作者：
Park, KH;Hwang, JM;Chung, H
目的：探讨2~15岁儿童退行性早产儿视网膜脱离的临床特点及手术治疗效果。结果：ROP急性期治疗后，8只眼表现为11级瘢痕改变，8只眼表现为III级，未发现任何证据表明ROP急性期及其治疗对瘢痕改变的程度有影响。瘢痕性ROP III级的8只眼均表现为牵拉性视网膜脱离(TRID)，11级的8只眼中有5只眼(62.5%)表现为孔源性视网膜脱离(RRD)。术后ROP消退至晚期视网膜脱离发生的时间，TRID组为20.7个月(12~61个月)，RRD组为85.8个月(33~148个月)。晚期脱离的平均年龄TRID组为34.1个月(26-73个月)，RRD组为98.6个月(45-162个月)。RRD的5只眼(20%)和TRID的11只眼(54.5%)中有1只眼解剖成功。与术前比较，RRD组有2只眼视力提高，3只眼无变化，视力下降；TRID组有3只眼，6只眼，2只眼。结论：晚期视网膜脱离是儿童期ROP退行性患者的主要视力威胁因素。这些患者的视力预后比那些发生在成人ROP患者的晚期视网膜脱离患者更差。因此，定期眼底检查应该在儿童期比成年期更频繁地进行，特别是对不会说话的儿童。
Purpose: To reveal the clinical features and surgical results of retinal detachment of regressed retinopathy of prematurity (ROP) that occur in the children aged 2 to 15 years.Patients and Methods: The records of patient who had a retinal detachment of a regressed ROP were retrospectively reviewed. Sixteen eyes from 15 patients that required surgical treatments due to retinal detachment of a regressed ROP were included.Results: After treatment of acute phase of ROP, eight eyes showed grade 11 of cicatricial change and eight eyes showed grade III. We did not find any evidence that the acute stages of ROP and its treatment affect the degree of the cicatricial changes. All eight eyes with grade III of cicatricial ROP showed tractional retinal detachment (TRID) and five of eight eyes (62.5%) with grade 11 showed rhegmatogenous retinal detachment (RRD). The mean interval between regressed ROP and development of late retinal detachment was 20.7 months (range, 12-61 months) in the TRID group and 85.8 months (range, 33-148) in the RRD group. The mean age at onset of late detachment was 34.1 months (range, 26-73 months) in the TRID group and 98.6 months (range, 45-162) in the RRD group. Anatomical success was achieved at one of five eyes (20%) with RRD and six of 11 eyes (54.5%) with TRID. Compared with the preoperative visual acuity, visual improvement, no change, and decreased visual acuity were achieved, respectively, in two eyes, three eyes, and no eyes in the RRD group and three eyes, six eyes, and two eyes in the TRID group. However, only two of 16 eyes with late retinal detachment achieved a visual acuity of 20/200 or better.Conclusion: Late retinal detachment is the main vision-threatening condition in patients with regressed ROP during childhood. The visual prognoses of these patients are poorer than those with late retinal detachments that occur in adult ROP patients. Therefore, a periodic fundus examination should be performed more frequently during childhood than in adulthood, particularly in nonverbal children.