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The review aims to evaluate the uses of conventional laser therapy and intravitreal injection of various anti-VEGF in terms of efficacy and side effects for the treatment of retinopathy of prematurity. A literature search of the publication, concerning conventional laser treatment and intravitreal injection of anti-VEGF for ROP. A total of 40 articles were reviewed after curation by the authors for relevance. Intravitreal anti-VEGF showed better ocular efficacy in zone I ROP while laser therapy had a lower recurrence rate in zone II. Comparing the two mainstay anti-VEGF agents, bevacizumab showed lower ROP recurrence rate than ranibizumab. Anti-VEGF has a higher chance in developing persistent peripheral avascularisation compared to conventional laser therapy, but a lower chance of developing high myopia. Ranibizumab has a lower systemic absorption than bevacizumab, despite having no difference in the incidence of persistent peripheral avascularisation. In conclusion, it is advised that intravitreal anti-VEGF should be used as the first-line treatment for zone I ROP while laser therapy should be the mainstay for zone II ROP owing to the different pathogenetic mechanisms. In patients with recurrence after initial anti-VEGF injection, that given ranibizumab may opt to repeat the injection while that given bevacizumab should consider supplement laser ablative treatment.摘要: 本综述旨在评价常规应用激光治疗和玻璃体内注射不同种抗血管内皮生长因子药物 (抗VEGF药物) 在治疗早产儿视网膜病变 (ROP) 中的疗效及不良反应。文章针对“常规激光治疗及玻璃体内注射抗VEGF药物在ROP治疗中的应用”进行了文献检索, 一共筛选出40篇相关文献。通过比较, 玻璃体内注射抗VEGF药物在I区ROP中疗效更好, 而使用激光治疗II区ROP复发率更低。对比两种主要的抗VEGF药物, 贝伐单抗治疗ROP的复发率低于雷珠单抗。与传统激光治疗相比, 抗VEGF治疗发展成持续性外周无血管的几率更高, 但发生高度近视的几率较低。雷珠单抗的全身吸收率低于贝伐单抗, 而在持续性外周无血管的发生率方面两者没有差异。总之, 由于发病机制不同, 本文推荐玻璃体内注射抗VEGF药物作为I区ROP的一线治疗用药, 而激光治疗应主要用于II区ROP的治疗。对于首次注射抗VEGF药物后复发的病人, 初次给予雷珠单抗治疗的人可选择重复注射, 而初次给予贝伐单抗治疗的人需考虑补充激光光凝治疗。. |
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