Decreased ocular blood flow after photocoagulation therapy in neonatal retinopathy of prematurity
Decreased ocular blood flow after photocoagulation therapy in neonatal retinopathy of prematurity
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DOI：
10.1007/s10384-017-0536-7
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发表时间：
2017-11-01
影响因子：
2.4
通讯作者：
Hori, Yuichi
中科院分区：
文献类型：
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作者：
Matsumoto, Tadashi;Itokawa, Takashi;Hori, Yuichi
为探讨激光散斑血流图（LSFG）测量的平均模糊率（MBR）与早产儿视网膜病变（ROP）光凝治疗的关系，我们对5例ROP新生儿在睡眠或镇静状态下进行了光凝治疗前后的研究，并对其中8只眼进行了连续3次循环测量。使用斯皮尔曼等级相关系数评价MBR-A（所有值的平均值）、MBR-V（血管平均值）和MBR-T（组织平均值）与经后年龄之间的相关性。此外，评估了相对MBR（-A，-V，-T）值与光凝烧伤次数和NV评分之间的相关性。ROP患者治疗后MBR与正常新生儿MBR之间的差异采用协方差分析（ANCoVA）进行估计，并对经后年龄进行校正。光凝后的相对MBR（-A，-V，-T）值分别为69.6 +/-16.0%，66.7 +/- 17.0%和74.3 +/-14.6%。月经后年龄与治疗后MBR-A（r = 0.83，p = 0.0101）、MBR-V（r = 0.85，p = 0.007）和MBR-T（r = 0.76，p = 0.0282）显著相关。相对MBR-T值与光凝灼伤次数（r =-0.75，p = 0.033）和NV评分（r =-0.72，p = 0.0437）显著相关。ANCoVA结果显示治疗后的MBR与正常新生儿的MBR无显著性差异。光凝改善了ROP患者的静脉扩张和动脉迂曲，减少了眼血流量。由于治疗后的MBR与正常新生儿的MBR没有不同，因此建议在严重ROP病例中治疗前的MBR更高。
To evaluate the relationships between optic nerve head blood flow, expressed as mean blur rate (MBR) measured by laser speckle flowgraphy (LSFG), and photocoagulation therapy in neonates with retinopathy of prematurity (ROP).Case series study.We studied 5 ROP neonates either during sleep or under sedation both before and after photocoagulation, and evaluated 8 eyes in which the circulation could be measured three times consecutively. Correlations between the MBR-A (mean of all values), MBR-V (vessel mean) and MBR-T (tissue mean) and postmenstrual age were evaluated using Spearman's rank correlation coefficient. In addition, correlations between the relative MBR (-A, -V, -T) value and number of photocoagulation burns and the NV score were evaluated. Differences between post-treatment MBR in ROP subjects and normal neonates' MBR were estimated using analysis of covariance (ANCoVA), with adjustment for postmenstrual age.The relative MBR (-A, -V, -T) values after photocoagulation were 69.6 +/- 16.0%, 66.7 +/- 17.0% and 74.3 +/- 14.6%, respectively. Postmenstrual age was significantly correlated with post-treatment MBR-A (r = 0.83, p = 0.0101), MBR-V (r = 0.85, p = 0.007) and MBR-T (r = 0.76, p = 0.0282). The relative MBR-T value was significantly correlated with the number of photocoagulation burns (r = -0.75, p = 0.033) and NV score (r = -0.72, p = 0.0437). The ANCoVA results showed no significant difference between post-treatment MBR and normal neonates' MBR.Photocoagulation improved the dilation of veins and tortuosity of arteries and reduced ocular blood flow in ROP subjects. Since the post-treatment MBR was not different from a normal neonate's MBR, it is suggested that the pre-treatment MBR was higher in severe ROP cases.