Comparison of aflibercept and bevacizumab in the treatment of type 1 retinopathy of prematurity

Hamid Riazi-Esfahani,Fatemeh Bazvand,Mehdi Sanatkar,Alireza Mahmoudi,Afsar Dastjani Farahani

doi:10.1186/s40942-021-00334-4

Hamid Riazi-Esfahani, Fatemeh Bazvand + Show 3 more

Open Access

https://doi.org/10.1186/s40942-021-00334-4

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Abstract

BackgroundTo evaluate the outcome of intravitreal bevacizumab (IVB) and aflibercept (IVA) injection for patients with retinopathy of prematurity (ROP).MethodsIn this single-center retrospective cohort, the recorded medical data of the infants who had been undergone intravitreal injection with either bevacizumab or aflibercept for type 1 ROP were reviewed. The infants were allocated into two groups. IVB group included patients who were treated with bevacizumab as initial treatment and the IVA group included patients who were treated with aflibercept as initial treatment. The rate and time of complete regression, as well as the recurrence rates, were compared between the groups.ResultsA total of 889 eyes of 453 infants were enrolled in the study. There were 865 eyes of 441 infants in the IVB group and 24 eyes of 12 infants in the IVA group. Follow-up time was 289 ± 257 days in the IVB group and 143 ± 25 days in the IVA group (p < 0.001). The difference in the ROP zone was not statistically significant between the 2 treatment groups (p = 0.328). All eyes in the IVA group showed initial regression of ROP after the intravitreal injections. These regressions were achieved in 830 (96.0%) eyes that were injected with IVB (p = 0.023). The median observed regression time was 10 days and 16 days in eyes treated with bevacizumab and aflibercept respectively. Recurrence was noted in 3.9% of eyes (34/865) in the IVB group and 58.3% of eyes (14/24) in the IVA group (p < 0.001).ConclusionWhile the regression rate in the IVA group was significantly higher than in the IVB group, the recurrence rate was significantly more in the IVA group, which may be attributed to differences in the pharmacokinetics of these drugs in the vitreous body.

Highlights

To evaluate the outcome of intravitreal bevacizumab (IVB) and aflibercept (IVA) injection for patients with retinopathy of prematurity (ROP)
IVB group included patients who were treated with bevacizumab as initial treatment and the intravitreal aflibercept (IVA) group included patients who were treated with aflibercept as initial treatment
A total of 889 eyes of 453 infants who were treated with either IVB or IVA were enrolled in the study

Summary

Introduction

To evaluate the outcome of intravitreal bevacizumab (IVB) and aflibercept (IVA) injection for patients with retinopathy of prematurity (ROP). Retinopathy of prematurity (ROP) still is one of the leading causes of permanent visual loss worldwide [1]. Dysregulation of vascular endothelial growth factor (VEGF) that leads to abnormal vasculogenesis as well as neovascularization is one of the causative factors for ROP development [3]. ROP is a biphasic disease consisting of an initial phase of oxygen-induced vascular abolition followed by a period of hypoxia-induced vessel proliferation due to VEGF rise [4]. Ablative therapies especially laser therapy was the preferred treatment for infants with ROP. These treatments destroy the peripheral avascular retina to regress the neovascularisation by decreasing the production of VEGF [5]

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