Anti-vascular Endothelial Growth Factor In The Treatment Of Retinopathy Of Prematurity

Objective: To observe the efficacy of intravitreal injection of anti-VEGF in the treatment of retinopathy of prematurity.Methods: Retrospective study.From February 2018 to December 2019,75 cases(146 eyes)of retinopathy of prematurity in Xiamen children’s hospital were randomly selected for the study.All patients were divided into groups according to the first treatment plan.22 cases(44 eyes)treated with conbercept was conbercept group,26cases(50 eyes)treated with ranibizumab was ranibizumab group.27 patients(52 eyes)treated with laser was laser group.To analyze the clinical factors of preterm infants,postoperative outcome and the intraocular pressure before and after conbercept injection and related factors.Results:The clinical factors of preterm infants in the three groups were:1、There was no significant difference in clinical factors between the conbercept group and ranibizumab group(P>0.05),the evaluation of therapeutic effect is comparable.2.The gestational age≤28w and birth weight≤950g,the number of patients in the two injection groups were higher than those in the laser group.The gestational age was29-30 w and the birth weight was 951-1300 g,the number of patients in the two injection groups was lower than that in the laser group.The therapeutic effect of three groups:1.The total effective rate of the three groups was 90.4%(132 / 146)within 2 months after operation;and that of the laser group was 100%(52 / 52),significant treatment effect;and that of the conbercept group was 88.64%(37 / 44),the rate of retreatment was 11.36%(5/44);and that of the ranibizumab group was 74.00%(43 / 50),the rate of retreatment was 26.00%(13 / 50).The total effective rate of the two injection groups was statistically significant(P <0.05),the conbercept group was higher than the ranibizumab group,but there was no improvement in the two groups after injection,and there was no statistically significant difference in the rate of retreatment(P >0.05).2.The need for further treatment was concentrated within 1 month.Two weeks after operation,one month after operation,the difference between the two groups was significant(P < 0.05).Two weeks after operation,the ranibizumab group was higher than the conbercept group;one month after operation,the conbercept group was higher than the Ranibizumab group.3.Crest regression in the two-drug group within two months after surgery: For prethreshold ROP type I,two weeks,one month after operation,the control rate of the two groups was significantly different(P<0.05);two weeks after operation,the control rate in conbercept group was lower than that in ranibizumab group;one month after operation,the control rate in conbercept group was higher than that in Ranibizumab group.For AP-ROP,Two weeks after operation,there was a significant difference in the control rate between the two groups(P < 0.05),the control rate in conbercept group was lower than that in ranibizumab group.4.Record of intraocular pressure before and after treatment in conbercept group: the change trend of intraocular pressure rising rate at each time after operation was first rising and then falling,and the peak value of intraocular pressure was 5 minutes after operation.The absolute value(the proportion of IOP≥21mmhg was 71.88%,the proportion of IOP≥25mmhg was 18.75%)and the rate of elevation(the proportion of IOP≥10mmhg was 71.88%,the proportion of IOP≥ 15 mmhg was 15.63%).Factors related to the increased value(≥15mm Hg)at 5min after operation,neovascularization and low birth weight were the risk factors,but there was no significant correlation between age,gender and intraocular pressure.Conclusions:1.Conbercept has the same effect as ranibizumab in controlling the continuing development of high-risk type I before threshold and AP-ROP.2.There was no difference between the two groups after relapse in the short term.In both pre threshold type I and AP-ROP,ranibizumab had more advantages in the early stage of disease control,but with the extension of observation period and 1 month after operation,conbercept group was better.This will provide a basis for clinical follow-up time after drug injection.3.Intraocular pressure returned to basic level 24 hours after intravitreal injection of conbercept.Attention should be paid to the intraocular pressure of low birth weight children and children with iris neovascularization before and after operation.This will provide a basis for the safety of conbercept injection.