早产儿视网膜病变3期治疗后和阈下3期自然转归的比较:对3个月和3年病变活动性、屈光力和解剖学变化的研究

来源 :世界核心医学期刊文摘.眼科学分册 | 被引量 : 0次 | 上传用户:wy83902
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Aim: To compare the visual acuity (VA), spherical equivalent refractive error, motility, and anatomical outcomes in children with treated regressed threshold stage3 retinopathy of prematurity (ROP) and those with spontaneously regressed subthreshold stage3 ROP. Method: 6 month and 3 year data collected from infants examined between 1989 and 1999 with regressed stage3 ROP, with or without treatment were retrospectively reviewed. Results: 85 infants were included in this study. 40 eyes received cryotherapy, 81 eyes laser photocoagulation, and 34 eyes had spontaneously regressed subthreshold stage3 ROP. Grating acuity score ≥ 2 cycles/degree (c/d) at 6 months was predictive of optotype acuity ≥ 6/9 in 69% of eyes and a score < 2 c/d at 6 months was predictive of acuity < 6/9 in 88% of eyes. Eyes with subthreshold stage3 ROP were twice as likely to haveVA of 6/9 or better at 36 months than the treated eyes. The mean spherical equivalent refractive error at 36 months was-6.5 dioptres (D) (-21.5D to + 1.38D) in cryotherapy treated eyes,-2.4D (-13D to + 4D) in the laser group, and-0.22D (-9D to + 2.25D) in the subthreshold group. Eyes within the treated groups were more myopic than the eyes within the spontaneously regressed group (P=0.005). At 36 months, 42 out of the 85 infants (that is, 49% ) had strabismus (44% in the cryotherapy group, 26% in the laser group, and 25% in the subthreshold group). There was a statistically significant association between the presence of strabismus and anisometropia (P=0.016) and strabismus and intraventricular haemorrhage (IVH) (P=0.005). There was a statistically significant difference in the incidence of strabismus between mild and moderate and severe grade IVH (P=0.01). Eight out of 40 eyes in the cryotherapy group and six out of the 81 eyes in the laser group developed macular ectopia. None of the eyes in the spontaneously regressed group had macular dragging. Conclusions: In this study, the grating acuity at 6 months was a good predictor of the 3 year optotype acuity in all groups. Eyes with spontaneously regressed subthreshold stage3 ROP were associated with better vision at 3 years of age and a lesser degree of myopia compared to the treated groups. Strabismus developed predominantly in the treated groups and was frequently associated with neurological damage and/or anisometropia. The spontaneously regressed subthreshold stage3 group had a better anatomical outcome compared to the groups in which the retinopathy regressed following treatment. Aim: To compare the visual acuity (VA), spherical equivalent refractive error, motility, and anatomical outcomes in children with treated regressed threshold stage3 retinopathy of prematurity (ROP) and those with spontaneously regressed subthreshold stage 3 ROP. Method: 6 month and 3 year data collected from infants examined between 1989 and 1999 with regressed stage 3 ROP, with or without treatment were retrospectively reviewed. Results: 85 infants were included in this study. 40 eyes received cryotherapy, 81 eyes laser photocoagulation, and 34 eyes had spontaneously regressed subthreshold stage 3 ROP. Grating acuity score ≥ 2 cycles / degree (c / d) at 6 months was predictive of optotype acuity ≥ 6/9 in 69% of eyes and a score <2 c / d at 6 months was predictive of acuity <6 / 9 in 88% of eyes. Eyes with subthreshold stage 3 ROP were twice as likely to have VA of 6/9 or better at 36 months than the treated eyes. The mean spherical equivalent refractive error at 36 months was-6.5 dioptres (D ) -21.5D to + 1.38D) in cryotherapy treated eyes, -2.4D (-13D to + 4D) in the laser group, and-0.22D (-9D to + 2.25D) in the subthreshold group. Eyes within the treated groups were more myopic than the eyes within the spontaneously regressed group (P = 0.005). At 36 months, 42 out of the 85 infants (that is, 49%) had strabismus (44% in the cryotherapy group, 26% in the laser group, and 25% in the subthreshold group). There was a significant association between the presence of strabismus and anisometropia (P = 0.016) and strabismus and intraventricular haemorrhage (IVH) (P = 0.005). There was a significant significant difference in the incidence of strabismus between mild and moderate and severe grade IVH (P = 0.01). Eight out of 40 eyes in the cryotherapy group and six out of the 81 eyes in the laser group developed macular ectopia. None of the eyes in the spontaneously regressed group had macular dragging. Conclusions: In this study, the grating acuity at 6 months was a good predictor of the 3 year optotype acuity in all groups. Eyes with spontaneously regressed subthreshold stage 3 ROP were associated with better vision at 3 years of age and a lesser degree of myopia compared to the treated groups. Strabismus developed predominantly in the treated groups and was frequently associated with neurological damage and / or anisometropia. The spontaneously regressed subthreshold stage3 group had a better anatomical outcome compared to the groups in which the retinopathy regressed following treatment.
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