Long-term effects of anti-VEGF therapy for retinopathy of prematurity

Abstract

Intravitreal anti-VEGF therapy is ahighly efficacious new treatment option for retinopathy of prematurity (ROP) with significant advantages over conventional therapy using retinal laser coagulation in selected cases. With growing experience in the clinical application over the last years, data about the potential long-term effects of this therapeutic approach are increasingly becoming available, such as those related to ROP-associated myopia, neurodevelopment and late recurrences of ROP. Knowledge of these effects is of direct relevance for the clinical management of affected children. The article is based on aliterature review of the covered topics. In addition to its therapeutic effect on retinal pathology, anti-VEGF therapy in ROP can also reduce ROP-associated myopia, most likely due to anormalization of anterior segment development. As the unresolved question of potential negative effects of bevacizumab on neurodevelopment remains of concern, the use of alternative treatment options, such as ranibizumab or laser coagulation should be considered. Treatment-requiring recurrences of ROP following anti-VEGF therapy have been reported as late as 69weeks postmenstrual age, indicating that long-term frequent ophthalmological follow-up examinations are required. Long-term effects of anti-VEGF therapy in ROP differ significantly from alternative treatment options such as laser coagulation. These differences are of relevance for the choice of treatment modality and the follow-up regimen of treated children.