摘要目的:观察减量阿柏西普治疗早产儿视网膜病变(ROP)的疗效。方法:采用非随机对照研究设计，纳入2018年12月至2020年5月于郑州大学第一附属医院就诊的ROP患儿38例76眼，根据监护人意愿将患儿分为雷珠单抗组21例42眼和减量阿柏西普组17例34眼。分别单次玻璃体腔注射雷珠单抗0.025 ml(0.25 mg)或阿柏西普0.012 5 ml(0.5 mg)。使用Retcam眼底照相观察注射后1、2、4周及2、3、6个月患者治疗应答情况，并计算2个组单次治疗有效率；使用Icare PRO磁性回弹式眼压计测量药物注射后1、10、30 min眼压；观察6个月随访期内眼部及全身并发症情况。结果:单次雷珠单抗和减量阿柏西普玻璃体腔注射后6个月随访期内有效率分别为90.5%(38/42)和88.2%(30/34)，2个组比较差异无统计学意义( χ2＝0.10， P＝0.75)，均未见眼部及全身并发症。术后1 min和10 min雷珠单抗组术眼眼压高于减量阿柏西普组，差异均有统计学意义(均 P<0.01)，2个组均在术后30 min恢复至基线水平。雷珠单抗组4眼单次注射治疗无效，其中2眼再次注射后有效，1眼行视网膜激光光凝术治疗后有效；1眼因急进型后极部ROP于治疗后1周进展为5期ROP，接受玻璃体切割术后，后极部视网膜复位良好。减量阿柏西普组治疗无效4眼，其中3眼再次注射阿柏西普后有效，1眼行视网膜激光光凝术治疗后有效。随访期内2个组均未见眼部及全身并发症。 结论:减量阿柏西普治疗ROP安全、有效，且对眼压影响较小。

abstractsObjective:To observe the effect of attenuated-dose aflibercept in the treatment of retinopathy of prematurity(ROP).Methods:A non-randomized controlled study was conducted, and 76 eyes of 38 ROP pediatric patients treated in First Affiliated Hospital of Zhengzhou University from December 2018 to May 2020 were enrolled.According to the requirements of their guardians, the patients were divided into ranibizumab group with 42 eyes of 21 cases and attenuated-dose aflibercept group with 34 eyes of 17 cases, and received intravitreal injection of ranibizumab 0.025 ml (0.25 mg) or aflibercept 0.012 5 ml (0.5 mg) according to grouping respectively.Retcam fundus photography was used to observe the treatment response at 1 week, 2, 4 weeks and 2, 3, and 6 months after treatment, and the effective rate at the end of follow-up was calculated.The intraocular pressure was measured with Icare PRO magnetic rebound tonometer at 1 minute, 10, and 30 minutes after injection. The ocular and systemic complications were observed during the 6-month follow-up period.All the guardians signed the informed consent prior to treatment.This study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University (No.2020-KY-228).Results:The effective rates of single ranibizumab and attenuated-dose aflibercept were 90.5% (38/42) and 88.2% (30/34), respectively, with no significant difference between the two groups ( χ2=0.10, P=0.75). The intraocular pressure of the ranibizumab group at 1 minute and 10 minutes after the operation were higher than those of the attenuated-dose aflibercept group, and the difference was statistically significant (both at P<0.01). The intraocular pressure recovered to the baseline level at 30 minutes after the operation.In the ranibizumab group, 4 eyes were ineffective after a single injection, among which 2 eyes were effective after second intravitreal injection of ranibizumab and 1 eye was effective after retinal laser photocoagulation treatment and 1 eye underwent vitrectomy due to the progress of retinal detachment one week after intravitreal injection, and the posterior retina reattached well.In the attenuated-dose aflibercept group, 4 eyes did not respond to treatment, of which 3 eyes were effective after second intravitreal injection of aflibercept, and 1 eye was effective after retinal laser photocoagulation.No ocular or systemic complications were observed during the followed-up period. Conclusions:Reduced dose of aflibercept is safe and effective in the treatment of ROP, and has little influence on intraocular pressure.