Current update on retinopathy of prematurity: screening and treatment.
Current update on retinopathy of prematurity: screening and treatment.
复制标题
当前有关早产视网膜病变的更新：筛查和治疗。
DOI：
10.1097/mop.0b013e3283423f35
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发表时间：
2011-04
影响因子：
3.6
通讯作者：
Smith LE
中科院分区：
文献类型：
--
作者：
Chen J;Stahl A;Hellstrom A;Smith LE
尽管目前的治疗，早产儿视网膜病变（ROP）仍然是早产儿失明的主要原因，发病率随着极早胎龄出生的婴儿存活率的增加而增加。本文综述了ROP的最新文献，特别关注治疗方案的最新进展以及新开发的疾病筛查方法。遗传学研究发现ROP的遗传易感性将Wnt途径中的基因与严重ROP的发展联系起来。关于诊断，已经开发了一种新的筛查方法，该方法允许仅基于出生后体重增加来预测ROP风险。以前，出生后体重增加与胰岛素样生长因子水平相结合被发现可以预测可治疗的ROP。已经提出了针对血管内皮生长因子（VEGF）的ROP严重病例的新治疗选择。然而，抗VEGF治疗对早产儿是否安全，还需要在对照临床试验中进一步评估。最后，来自早期治疗ROP组的新报告表明，早期激光治疗1型而非2型高危阈值前ROP可改善6岁时的视力结局。随着早产儿存活率的提高和ROP发病率的增加，筛查ROP风险并及时治疗高危患者以保护其视功能并减少并发症非常重要。
Despite current treatments, retinopathy of prematurity (ROP) remains a major cause of blindness in premature infants and the incidence is increasing with increased survival of infants born at very early gestational ages. This review summarizes the recent literature on ROP with a special focus on recent advances in treatment options as well as newly developed methods for disease screening. Genetic studies find a genetic predisposition to ROP linking genes in the Wnt pathway with development of severe ROP. With regard to diagnosis, a new screening method has been developed that allows prediction of ROP risk based on postnatal body weight gain alone. Formerly weight gain postnatally in combination with insulin-like growth factor levels was found to predict treatable ROP. New treatment options for severe cases of ROP have been proposed targeting vascular endothelial growth factor (VEGF). Whether anti-VEGF treatment is safe in preterm infants, however, has to be further evaluated in controlled clinical trials. Finally, new reports from the early treatment ROP group suggest that early laser treatment for type 1 but not type 2 high-risk pre-threshold ROP improves visual acuity outcomes at 6 years of age. With the increasing survival of premature infants and increased incidence of ROP, it is important to screen for ROP risk and treat at-risk patients in a timely manner to preserve their visual function and reduce complications.