Retinopathy of prematurity (ROP) is one of the leading causes of visual impairment in children. As understanding on the pathogenesis of ROP accumulated, anti-vascular endothelial growth factor (VEGF) drugs and their application have changed the treatment mode. Anti-VEGF therapy, with convenient operation and clear efficacy, has become an important treatment method for ROP. However, due to the dysfunction of organs in children with ROP, anti-VEGF drugs can enter blood circulation after intravitreal injection and then lead to temporarily reduction of the VEGF level in the blood, which may theoretically cause adverse effects on the development of all organs (especially the brain) in children with ROP. Therefore, it's necessary to pay attention to the effect of anti-VEGF drugs on neurodevelopment in children with ROP, strictly grasp the indications, and standardize its clinical application, so as to continuously improve the overall prognosis of ROP.
In recent years, with the deepening of understanding of children's retinal diseases and the continuous updating of treatment techniques, the efficacy of children's retinal diseases has also been improved. Due to the particularity of the anatomical structure of the retina of children in the growth and development stage and the pathogenesis, clinical manifestations and outcomes of children's retinal diseases are different from those of adults, the principles of treatment of adult retinal diseases cannot be directly applied to children's retinal diseases. Cryotherapy, laser photocoagulation, intravitreal injection of anti-VEGF drugs, and vitreoretinal surgery are the main treatment methods for children's retinal diseases. However, there are still many problems in the selection of indications, equipment parameters, and treatment of complications. The treatment norms of the disease need to be further improved. Therefore, research on the treatment of children's retinal diseases, and the establishment of surgical standards and norms through expert consensus and other methods are helpful for the treatment of children's retinal diseases.
Fundus photograph, angiography, optical coherence tomography, ultrasonography and other image technology and visual electrophysiology can provide a wealth of information for the diagnosis and treatment of pediatric retinal diseases. However, it put forward higher requirements on pediatric retinal imaging equipment and techniques which will be quite different from adult, because of pediatric retinal disease has its own characteristics, such as disease spectrum, pathogenesis, and pathophysiology. The principles and methods of image results interpretation on adult were not quite ready for children. It is necessary to further study the fundus imaging techniques suitable for children, gradually establish standardized examination procedures and clinical interpretation system, to promote the diagnosis of retinopathy in children.
Objective To observe the therapeutic efficacy of widefi eld digita l pediatric retinal imaging system (RetCam II)assisted photocoagulation on ret in opathy of preamturity (ROP). Methods The clinical data of 30 p atie nts (58 eyes) with threshold ROP or prethreshold type I ROP were retrospectively analyzed. The nonperfusion area underwent semiconducting photocoagulation wit h 532 nm under indirect binocular ophthalmoscope. In 30 patients, prethreshold ty pe 1 ROP was found in 36 and threshold ROP was in 19; missed area after cryotherapy in other hospital was observed in 3; Zone 1 ROP was in 8 and z one 2 ROP was in 50. Fiftyfour eyes (93.1％) underwent onetime photocoagulat i on and 4 eyes (6.9%) underwent a second. Ocular fundus was examined by RetCam II before and after operation. The missed area after cryoth erapy was at once supplemented during surgery. The followup duration was 3－11 m onths (average of 5.5 months). Results Fiftyfour eyes which had under gone onetime photocoagulation had good result 1－3 weeks after surgery and the disease was controlled. In 4 eyes which had undergone t he second photoco agulation, the disease alleviated after the operation in 2 and local posterior t ractional retinal detachment occurred in 2. At the end of followup duration, u n favorable retinal structural outcome was observed in 2 eyes (3.4%). Con clusion R etCam IIassisted photocoagulation can avoid missed area during the operation， enhance successful rates of first photocoagulation and reduce unfavorabl e retinal structural outcome rates.