Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence.

Kaveh Fadakar,Mostafa Heidari,Afsar Dastjani Farahani,Afsaneh Azarkish,Fatemeh Bazvand,Mohammadreza Mehrabi Bahar,Hamid Riazi-Esfahani

doi:10.1007/s10792-021-02198-x

Kaveh Fadakar, Mostafa Heidari + Show 5 more

https://doi.org/10.1007/s10792-021-02198-x

Copy DOI

Export

Save

Cite

Abstract
Highlights/Summary
Full-Text
Similar Papers

Abstract

Listen

This study aimed to evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP). This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal bevacizumab from 2012 to 2019. Medical records of patients were evaluated. Mean gestational age (GA) and birth weight of patients were 28 ± 2weeks and 1121 ± 312g, respectively. Thirty-five eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64 ± 13.68days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis. The recurrence occurred in 33 eyes (3.97%) of them in 20 patients, with the meantime of 77.52days after the first treatment (IVB). The presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with significantly increased prevalence of treatment failure. The risk factors predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis. Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Awareness of risk factors for treatment failure and recurrence may help clinicians to schedule more vigilant approach in susceptible cases.

Highlights

Retinopathy of prematurity (ROP) is a vasoproliferative disease of the immature retina and one of the major preventable causes of childhood blindness.[1]
Since BEAT-ROP study, there is an increasing trend toward less invasive intravitreal injection of anti-VEGF drugs like Bevacizumab and Ranibizumab, especially zone 1.4,5 Anti-VEGF treatment will result in more rapid regression of abnormal vessels and more feasible in the eyes with rigid pupils and lower chance of unfavorable outcomes in type 1 ROP like high myopia.[6,7]
We present the results of large case series of ROP-treated infants treated with intravitreal Bevacizumab to report the rate of primary failure and recurrence in these patients and the timing of recurrence

Summary

Introduction

Retinopathy of prematurity (ROP) is a vasoproliferative disease of the immature retina and one of the major preventable causes of childhood blindness.[1]. Since BEAT-ROP study, there is an increasing trend toward less invasive intravitreal injection of anti-VEGF drugs like Bevacizumab and Ranibizumab, especially zone 1.4,5 Anti-VEGF treatment will result in more rapid regression of abnormal vessels and more feasible in the eyes with rigid pupils and lower chance of unfavorable outcomes in type 1 ROP like high myopia.[6,7] anti-VEGF administration are less cumbersome to deliver in comparison to standard laser treatment, as long as it let the immature retina continue its vascular development, but side effects remain a big concern.[8,9]

Objectives

Methods

Results

Conclusion