SEVERE RECURRENT FIBROVASCULAR PROLIFERATION AFTER COMBINED INTRAVITREAL BEVACIZUMAB INJECTION AND LASER PHOTOCOAGULATION FOR AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY
SEVERE RECURRENT FIBROVASCULAR PROLIFERATION AFTER COMBINED INTRAVITREAL BEVACIZUMAB INJECTION AND LASER PHOTOCOAGULATION FOR AGGRESSIVE POSTERIOR RETINOPATHY OF PREMATURITY
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DOI：
10.1097/icb.0000000000000887
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发表时间：
2019-07
影响因子：
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通讯作者：
Shin Tanaka;T. Yokoi;S. Katagiri;Tomoyo Yoshida;S. Nishina;N. Azuma
中科院分区：
文献类型：
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作者：
Shin Tanaka;T. Yokoi;S. Katagiri;Tomoyo Yoshida;S. Nishina;N. Azuma
文本中提供了补充数字内容。尽管使用玻璃体内贝伐单抗和激光光凝治疗，患有侵袭性早产儿后部视网膜病变的眼睛仍可能出现严重的纤维血管增生。目的：描述玻璃体内注射贝伐单抗和激光光凝治疗早产儿侵袭性后部视网膜病变后严重复发性纤维血管增生的临床特征。方法：这个回顾性、非随机病例系列回顾了转诊医院和我们医院的医疗和眼科记录。患者：四名患有侵袭性早产儿后部视网膜病变的患者（七只眼睛）。结果：患者在玻璃体内注射贝伐单抗和激光光凝联合治疗后，因复发性纤维血管增生伴牵拉性视网膜脱离而被转诊进行玻璃体切除术（联合/不联合晶状体切除术）。 3 名患者在胎龄 22 周或 23 周时出生，1 名患者在胎龄 29 周时出生。术前荧光素血管造影显示所有眼均因玻璃体内注射贝伐单抗后3个月至5个月纤维血管增生再生而出现牵拉性视网膜脱离以及视网膜血管系统异常；四只眼睛的视网膜广泛缺血。术后，四只眼出现视网膜附着，三只眼出现视网膜完全脱离。在临床过程中，七只眼睛中的五只出现了新生血管性青光眼。结论：玻璃体腔内注射贝伐珠单抗和激光光凝联合治疗作为早产儿侵袭性后部视网膜病变的初始治疗失败后，由于广泛的视网膜缺血、毛细血管脱落和脉管系统异常，可能会导致严重的纤维血管增生复发。仔细的随访非常重要，尤其是在抗血管内皮生长因子治疗后，因为认识到严重的再激活是可能的。
Supplemental Digital Content is Available in the Text. Severe fibrovascular proliferation can develop in eyes with aggressive posterior retinopathy of prematurity despite treatment with intravitreal bevacizumab and laser photocoagulation. Purpose: To describe the clinical features of severe recurrent fibrovascular proliferation after intravitreal bevacizumab injections and laser photocoagulation for aggressive posterior retinopathy of prematurity. Methods: This retrospective, nonrandomized case series reviewed the medical and ophthalmic records in the referral hospital and our hospital. Patients: Four patients (seven eyes) with aggressive posterior retinopathy of prematurity. Results: The patients were referred for vitrectomy with/without lensectomy for recurrent fibrovascular proliferation with a tractional retinal detachment after combined intravitreal bevacizumab injections and laser photocoagulation. Three patients were born at 22 weeks or 23 weeks' gestational age and one patient at 29 weeks' gestational age. Preoperatively, fluorescein angiography images showed all eyes had tractional retinal detachment from regrowth of fibrovascular proliferation 3 months to 5 months after the intravitreal bevacizumab injection and abnormal retinal vasculature; four eyes had a broad ischemic retina. Postoperatively, four eyes had retinal attachment and three eyes a total retinal detachment. Neovascular glaucoma developed in five of the seven eyes during the clinical course. Conclusion: Severe fibrovascular proliferation may recur due to widespread retinal ischemia with capillary dropout and abnormal vasculature after failed combined intravitreal bevacizumab and laser photocoagulation therapy as the initial treatment for aggressive posterior retinopathy of prematurity. Careful follow-up is important especially after anti–vascular endothelial growth factor treatment, with recognition that severe reactivation is possible.