| Purpose:To study and analyze the choice of ROP treatment methods and the changes in laser treatment before and after the use of anti-VEGF drugs to provide a better plan for the diagnosis and treatment of clinical ROP.Methods: This study selected 196 premature infants(352 eyes)who were diagnosed with ROP and treated in Tongji Hospital of Huazhong University from February 2012 to July 2019,all infants were divided into four groups according to the time of treatment of ROP with anti-VEGF drugs(2014):1.Laser group before 2014,patients with ROP were treated with laser before the use of anti-VEGF drugs;2.Laser group after 2014,patients with ROP were treated with laser after the use of anti-VEGF drugs;3.simple anti-VEGF group,including the first choice of anti-VEGF drug treatment or use anti-VEGF drugs again after recurrence;4.laser group after anti-VEGF,include patients who were recurrence after anti-VEGF treatment then chose laser treatment.To retrospectively analyze the gestational age,birth weight,diagnosis type,corrected gestational age during treatment,laser parameters of laser photocoagulation,and the recurrence of the four groups,using independent sample t test and ANOVA precise test and chi-square test to analyze changes in ROP treatment.Results: 1.A total of 44 cases(82 eyes)in the laser group before 2014,a total of 44cases(73 eyes)in the laser group after 2014,a total of 11 cases(21 eyes)in the laser group after anti-VEGF,and 97 cases(176 eyes)in the simple anti-VEGF group.2.In the laser group after 2014,the number of AP-ROP cases was 0,After 2014,all AP-ROP premature select anti-VEGF therapy,and some recurrence cases were treated with laser.3.Gestational age,birth weight,corrected gestational age during treatment,and the number of laser spots among three laser groups were significantly different(P<0.05).The gestational age and birth weight of laser group after anti-VEGF were smaller than laser group after 2014 and laser group before 2014,and the difference was statistically significant(P<0.05).Corrected gestational age during treatment: laser group after anti-VEGF> laser group after 2014> laser group before 2014,the difference between any two groups was statistically significant(P <0.05).the number of left and right eye laser spots in the laser group before 2014 was greater than that of the other two groups,and the difference was statistically significant(P <0.05).The differences in the number of left-eye laser spots and the number of right-eye laser spots in each group were not statistically significant(P> 0.05).4.A total of 38 patients(74 eyes)with AP-ROP,a total of 75 patients with threshold disease,and 109 patients(193 eyes)with type 1 disease,The gestational age,birth weight,and correction during treatment of each diagnosis type were significantly different.The gestational age and birth weight of AP-ROP were greater than the threshold disease and type 1 disease,and the difference was statistically significant(P<0.05).The corrected gestational age during treatment of AP-ROP was less than the threshold disease and type 1 disease,and the difference was statistically significant(P<0.05).5.A total of 7 patients(10 eyes)with type 2 disease were corrected for average gestational age of 46.29 ± 7.39 weeks during treatment.The average number of light spots in the right eye of preterm infants treated with laser was 317 ± 41,and the average number of light spots in the left eye was 414 ± 198.Conclusion: The majority of ROP occurs symmetrically in both eyes.Low gestational age and low body weight are risk factors for ROP,Lower gestational age(<28 weeks)and lower birth weight(<1000 grams)may be the risk factors for ROP recurrence after anti-VEGF treatment.AP-ROP is the preferred anti-VEGF treatment.When the disease is close to the posterior pole and the child’s corrected gestational age is small,anti-VEGF treatment should be used if ROP needs treatment.When the disease is near zone Ⅲ and needs treatment,if the child’s corrected gestational age is greater than 40 weeks,laser photocoagulation can be given priority.when the recurrence of the disease requires treatment and the correction of gestational age is greater than 40 weeks,if the disease is close to the area Ⅲ,choose laser photocoagulation treatment,which can not only reduce the risk of surgery,but also enable the patients to obtain better retinal anatomy.The type 2 disease has persistent and non-resolving disease,which have certain risks,laser photocoagulation can be given to eliminate hidden dangers. |
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