Resultados visuais, refrativos e estruturais em longo prazo em bebês prematuros tratados para retinopatia da prematuridade
DOI:
https://doi.org/10.70313/2718.7446.v17.n03.343Palavras-chave:
retinopatia da prematuridade, fotocoagulação a laser, injeção intravítrea antiangiogênica, miopiaResumo
Objetivo: Analisar a acuidade visual melhor corrigida, o estado refrativo e os resultados anatômicos em longo consecutivamente com ROP por fotocoagulação a laser agentes antiangiogênicos.
Métodos: Estudo analítico retrospectivo. Foram incluídas intravítreas de agentes antiangiogênicos, ou ambos, e que tiveram acompanhamento oftalmológico mínimo de três anos pós-tratamento. Foram utilizadas estatísticas descritivas e de frequência, e para associação estatística foram utilizados o teste Qui-quadrado e o teste de correlação de Spearman.
Resultados: Foram estudados 123 olhos de 62 pacientes. A idade no último controle foi em média 9,66 ± 5,61 anos. 116 olhos (94%) foram tratados com fotocoagulação a laser, 5 (4%) olhos necessitaram de tratamento combinado e 2 (2%) olhos com injeção intravítrea de antiangiogênicos. O equivalente esférico médio foi de -2,68±4,87 dioptrias, sendo significativamente mais negativo naqueles com tratamento combinado (-11,54±2,36 D) e retratamento (-12,46±3,26 D) e naqueles com doença da zona posterior (-7,50±5,49 vs + 0,52±0,54 D) (p<0,01). Dezesseis (15%) olhos eram emétropes, 32 (29%) olhos eram hipermétropes e 62 (57%) olhos eram míopes. 82
(74%) olhos apresentavam astigmatismo e 20 (37%) pacientes apresentavam anisometropia. Sessenta (60%) olhos tinham boa acuidade visual, 26 (25%) olhos tinham acuidade visual razoável e 16 (15%) tinham baixa acuidade visual. Em 97 (80%) olhos o fundo não apresentava sequelas da doença ou de outras patologias.
Conclusões: A maioria das crianças tratadas mantém boa acuidade visual, apesar de erros refrativos significativos, principalmente miopia. Quanto mais tardia for a doença, maior será a prevalência de alta miopia.
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