论文部分内容阅读
目的:观察小婴儿色素失禁症（IP）患儿的眼部临床特征及疗效。方法:回顾性临床病例研究。2017年10月至2021年2月于河南省儿童医院眼科就诊的0~3月龄小婴儿IP患儿18例36只眼纳入研究。所有患儿均在表面麻醉或全身麻醉下行眼底检查。行基因检测9例。根据眼底病变程度选择是否行视网膜激光光凝（LIO）、玻璃体腔注射康柏西普（IVC，0.25 mg/0.025 ml）治疗。治疗后随访时间4~43个月。观察患儿眼部临床特征和疗效。结果:18例患儿中，男性1例，女性17例；首诊年龄（1.2±1.0）个月（2 d~3个月）。均有典型的皮肤改变。合并神经系统异常4例；牙齿异常10例；瘢痕性脱发4例。行基因检测的9例中，n IKBKG基因第4~10外显子缺失5例；n IKBKG基因第9号外显子发生c.1124delT杂合突变1例。18例36只眼中，IP相关眼部病变13例21只眼（58.3%，21/36），均为视网膜病变。双眼病变不对称9例（69.2%，9/13）。21只眼中，单纯视网膜色素上皮异常沉着3只眼（14.3%，3/21）；视网膜血管异常改变18只眼（85.7%，18/21）。36只眼中，接受治疗8只眼。其中，LIO治疗4只眼；IVC治疗3只眼；IVC联合LIO治疗1只眼。治疗后患眼病情均得到有效控制。视网膜全脱离1只眼，因监护人拒绝而未行手术治疗，随访过程中出现知觉性外斜视，眼球萎缩。n 结论:IP相关眼部病变发病早，以视网膜血管异常改变为主；早期治疗效果较好。“,”Objective:To observe the ocular clinical features and efficacy of young infants with incontinentia pigmenti (IP).Methods:A retrospective study. Clinical data of 18 young infants with IP aged 0-3 months in the Department of Ophthalmology of Henan Children\'s Hospital from October 2017 to February 2019 were collected in this study. All patients were underwent fundus examination under topical anesthesia or general anesthesia. Among them, 9 cases were underwent genetic testing. Patients were determined whether to treated with retinal laser photocoagulation (LIO) or intravitreal conbercept (IVC, 0.25 mg/0.025 ml) according to the condition of eyes. The followed-up time ranged from 4months to 43 months. The ocular clinical features and treatment were observed.Results:There were 1 male and 17 females of the 18 patients. The age of first visit were 1.2±1.0 months (2 d-3 months). All cases had typical skin lesions, 4 cases had neurological symptoms, 10 cases had tooth abnormalities, and 4 cases had cicatricial alopecia. Among the 9 cases that were underwent genetic testing, 5 cases were deleted in exons 4-10 of the n IKBKG gene and 1 case were a heterozygous mutation c.1124delT in exon 9 of the n IKBKG gene. Among the 36 eyes, 21 eyes of 13 cases with incontinentia pigmenti-associated ocular diseases were all retinopathy (58.3%,21/36). Retinopathy of 9 cases were asymmetrical (69.2%,9/13). Among the 21 eyes, 3 eyes were simple retinal pigment abnormalities (14.3%,3/21) and 18 cases had retinal vascular lesion (85.7%, 18/21). Among the 36 eyes, 8 eyes were treated; 4 eyes were underwent LIO; 3 eyes were treated with IVC; 1 eye was treated with LIO combined with IVC. They were all improved significantly after the operation without serious complications. 1 eye with retinal detachment did not undergo surgical treatment due to guardian reasons. Perceptual exotropia and eyeball atrophy was found during the follow-up.n Conclusions:The onset of IP-related ocular anomalies is early. The early anomalies were mainly retinal vascular abnormalities. Treatment in early time is effective.