抗VEGF药物治疗早产儿视网膜病变的不良反应与管理策略

Adverse Effects and Management Strategies of Anti-VEGF Therapy for Retinopathy of Prematurity

摘要: 早产儿视网膜病变(Retinopathy of Permaturity, ROP)是一种发生在早产儿中的一种视网膜血管增殖性疾病。由于受到多种风险因素的共同作用，早产儿视网膜无法发育至完全状态，引发视网膜缺血，进一步致使大量新生血管生成，甚至出现牵拉性视网膜脱离。目前针对ROP的治疗，主要包括视网膜激光光凝术、玻璃体腔内注射抗血管内皮生长因子(VEGF)药物，以及玻璃体视网膜手术。随着对VEGF在ROP发病机制中作用认识的深入，玻璃体腔注射抗VEGF药物正逐渐成为ROP治疗的重要选择。ROP的病理机制与VEGF介导的病理性血管增生密切相关，传统激光治疗虽有效但可能导致近视加重和视网膜结构损伤。抗VEGF药物通过靶向抑制VEGF，显著改善急性期病变，且具有微创优势，逐渐成为一线治疗方案。然而，其带来的不良反应如局部并发症、全身风险、长期影响等仍需要引起重视，本文主要就抗VEGF药物治疗ROP的不良反应与管理策略进行如下综述。

Abstract: Retinopathy of Prematurity (ROP) is a retinal vasoproliferative disorder occurring in preterm infants. Under the influence of multiple risk factors, the immature retina fails to complete normal vascularization, leading to retinal ischemia, pathological neovascularization, and even tractional retinal detachment. Current therapeutic approaches for ROP include retinal laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents, and vitreoretinal surgery. With advancing understanding of VEGF’s pivotal role in ROP pathogenesis, intravitreal anti-VEGF therapy has emerged as a critical treatment option. The pathological mechanisms of ROP are closely linked to VEGF-mediated aberrant angiogenesis. While conventional laser therapy remains effective, it may exacerbate myopia and induce structural retinal damage. Anti-VEGF agents, by selectively inhibiting VEGF signaling, significantly ameliorate acute-phase pathology and offer minimally invasive advantages, positioning them as first-line therapeutics. However, their associated adverse effects—including local complications, systemic risks, and long-term sequelae—warrant rigorous attention. This review comprehensively examines the adverse effects and management strategies of anti-VEGF therapy in ROP.