| 【摘要】目的：探讨和评价Ⅰ区急进性早产儿视网膜病变（retinopathy of prematurity,ROP）的临床特征及治疗。方法： 回顾分析2005年1月至2006年12月期间经早产儿双目间接眼底镜筛查发现的Ⅰ区急进性ROP患儿6人（12只眼），采用广域数字化小儿视网膜图像系统（RectcamII）对其眼底病变情况进行观察记录，并对患儿进行眼底视网膜激光和（或）冷冻治疗。结果：患儿12只眼于确诊后平均2天进行眼底视网膜激光和（或）冷冻治疗，其中6只眼（50％）病变完全退化，包括初次激光或冷凝治疗即退化者4只眼，通过二次激光联合冷凝治疗退化者2只眼，另外6只眼（50％）出现预后不良，包括2只眼残存视网膜增值牵引病变，并进展为局限性视网膜脱离，2只眼发生玻璃体积血，另外2只眼最终进展为全视网膜脱离至眼球萎缩。结论：Ⅰ区急进性早产儿视网膜病变发病时间早，病程呈不循常规的爆发性骤进性发展，预后较差，其手术时间应尽可能提前，该类型病变与其他区域的ROP病变机制可能涉及两种不同的临床病理过程
【Abstract】Objective To study the clinical characteristics and treatment outcomes after laser and cryotherapy in premature infants with zone I acute retinopathy of prematurity (ROP).Methods 12 eyes of 6 premature infants diagnosed as zone I acute ROP by binocular indirect ophthalmoscope were analyzed. All infants were examined by digital photography using the RetCam Digital Retinal Camera. They were treated with retinal photocoagulation or cryotherapy．Results 12 eyes underwent retinal photocoagulation or cryotherapy on the average of 2 days after being diagnosed.ROP regressed completely in 6 eyes(50%),including 4 eyes that underwent retinal ablation only once and 2 eyes which underwent secondary photocoagulation or cryotherapy. Unfavorable outcome was observed in 6 eyes(50%) that included peripheral retinal detachment in 2 eyes, vitreous hemorrhage occurred in 2 eyes and dragged retinal detachment in 2 eyes.Conclusion Zone I acute retinopathy of prematurity has a specific clinical appearance and poor prognosis.It is suggested that retinal photocoagulation or cryotherapy should be performed as soon as possible after being diagnosed.There were two distinct mechanisms between zones I and any other zone ROP.
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