Retinoschisis Detected With Handheld Spectral-Domain Optical Coherence Tomography in Neonates With Advanced Retinopathy of Prematurity
Retinoschisis Detected With Handheld Spectral-Domain Optical Coherence Tomography in Neonates With Advanced Retinopathy of Prematurity
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DOI：
10.1001/archophthalmol.2009.361
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发表时间：
2010-01-01
影响因子：
--
通讯作者：
Lee, Thomas C.
中科院分区：
文献类型：
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作者：
Muni, Rajeev H.;Kohly, Radha P.;Lee, Thomas C.
目的：手持式光谱域光学相干断层扫描（HHSD-OCT）的最新发展使我们能够获得早产儿视网膜病变（ROP）的高分辨率视网膜扫描。本研究的目的是记录激光治疗的进展性ROP新生儿HHSD-OCT的表现。方法：对3例经激光光凝治疗的进行性ROP患者进行回顾性分析。所有患者均从周边新生儿重症监护病房（NICUs）转至洛杉矶儿童医院。所有患者均进行了完整的眼部检查、眼底摄影、荧光素血管造影和hsd - oct。结果：3例患者均有主动进行性ROP，尽管既往有激光光凝治疗。在6只眼睛中，有1只眼睛因激光光凝后出现渗出性视网膜脱离而被排除在研究之外。其余5只眼临床检查未见视网膜脱离，但其中3只眼脊处有玻璃体视网膜牵拉。hsd - oct在所有5只研究眼中发现推定的视网膜裂。结论：牵引性视网膜裂可能是进展性激光治疗ROP的重要发现，通过hsd - oct可以实现。这一发现可能对我们如何分类和治疗尽管激光治疗仍有进展的ROP患者具有重要意义。此外，hsd - oct的使用可以对进行性ROP患者视网膜、玻璃体和视网膜嵴的相互作用提供有价值的见解，并且可以比其他方法更早、更准确地诊断出浅脱离和视网膜裂。
Objectives: The recent development of handheld spectral-domain optical coherence tomography (HHSD-OCT) has enabled us to obtain high-resolution retinal scans of premature infants with retinopathy of prematurity (ROP). The purpose of this study is to document HHSD-OCT findings in laser-treated neonates with progressive ROP.Methods: This is a retrospective consecutive case series of 3 patients with progressive ROP despite laser photocoagulation. All patients were transferred from peripheral neonatal intensive care units (NICUs) to the Children's Hospital Los Angeles. All patients had a complete ocular examination, fundus photography, fluorescein angiography, and HHSD-OCT.Results: All 3 patients had active progressive ROP despite prior laser photocoagulation. Of the 6 eyes, 1 was excluded from the study because it had an exudative retinal detachment following laser photocoagulation. Retinal detachment was not detected on clinical examination in the 5 remaining eyes, although there was vitreoretinal traction at the ridges of 3 of the 5 eyes. The HHSD-OCT identified presumed retinoschisis in all 5 study eyes.Conclusions: Tractional retinoschisis may be an important finding in progressive laser-treated ROP, made possible by use of the HHSD-OCT. This finding may have significant implications for how we classify and treat patients whose ROP is progressing despite laser treatment. Furthermore, the use of the HHSD-OCT can provide valuable insight into the interaction of the retina, vitreous, and ridge in patients with progressive ROP, and it allows shallow detachments and retinoschisis to be diagnosed earlier and more accurately than would otherwise be possible.