Choroidal ruptures after adjuvant intravitreal injection of bevacizumab for aggressive posterior retinopathy of prematurity
Choroidal ruptures after adjuvant intravitreal injection of bevacizumab for aggressive posterior retinopathy of prematurity
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DOI：
10.1038/jp.2009.166
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发表时间：
2010-07-01
影响因子：
2.9
通讯作者：
Trinavarat, A.
中科院分区：
文献类型：
--
作者：
Atchaneeyasakul, L-O;Trinavarat, A.
近年来，激光治疗联合玻璃体内注射贝伐单抗（阿瓦斯汀）已很少用于治疗患有侵袭性早产儿后部视网膜病变（ROP）的患者。我们描述了一名妊娠 28 周出生、出生体重为 1190 克的早产儿在联合治疗后 10 周时记录的脉络膜破裂情况。 6 周岁时诊断出侵袭性后 ROP。初始治疗包括双侧激光消融，随后立即在右眼进行玻璃体内注射贝伐单抗（IVB，0.75 mg）。第5天，仅在右眼中观察到加号和纤维血管增殖的显着消退。此时，对左眼进行了额外的激光治疗并结合 IVB，疾病和新血管形成得到了显着解决。左眼 IVB 术后 10 周，沿激光疤痕后缘发现两个脉络膜破裂部位。没有证据表明脉络膜新生血管形成与脉络膜破裂相关。激光消融加 IVB 治疗侵袭性后 ROP 后不久可能会发生脉络膜破裂。这种情况需要识别以确定它是否确实与治疗有关。长期随访对于了解这种潜在严重并发症的性质和进展非常重要。围产期杂志 (2010) 30, 497-499; doi：10.1038/jp.2009.166
In recent times, laser treatment combined with intravitreal bevacizumab (Avastin) has been used rarely as early investigations to treat patients with aggressive posterior retinopathy of prematurity (ROP). We describe choroidal ruptures that were documented at 10 weeks after this combined treatment in a preterm infant born at 28 weeks gestation with a birth weight of 1190 g. Aggressive posterior ROP was diagnosed at the age of 6 weeks. Initial treatment included bilateral laser ablation, followed immediately by intravitreal bevacizumab (IVB, 0.75 mg) in the right eye. On day 5, a remarkable regression of plus sign and fibrovascular proliferation was noted only in the right eye. At this point, additional laser treatment combined with IVB was given in the left eye, which dramatically resolved plus disease and neovascularization. At 10 weeks after IVB in the left eye, two sites of choroidal ruptures were revealed along the posterior edges of laser scars. There was no evidence of choroidal neovascularization associated with the choroidal ruptures. Choroidal rupture may occur shortly after laser ablation plus IVB treatment for aggressive posterior ROP. This occurrence requires recognition to determine whether it is actually related to the treatment. Long-term follow-up is important for understanding the nature and progression of this potentially serious complication. Journal of Perinatology (2010) 30, 497-499; doi: 10.1038/jp.2009.166