Abstract
To evaluate the efficiency of low-dose intravitreal ranibizumab therapy in the treatment of aggressive retinopathy of prematurity (A-ROP). A total of 124 eyes of 62 patients who underwent intravitreal ranibizumab after an A-ROP diagnosis between January 2015 and January 2021 were evaluated retrospectively. After receiving family-approved informed consent, low-dose intravitreal ranibizumab was administered, and regular follow-ups were performed. Patients included in the study had a mean birth week of 26.6 (23-33weeks), a mean birth weight of 905 (450-1970) grams, and an average injection postnatal time of 9.1 (4-19) weeks. The mean follow-up period was 63 (24-250) weeks. In all eyes, ROP regressed in the first week after injection, and no asymmetrical response was observed in the eyes of any baby. A total of 58 eyes recovered with a single dose of intravitreal injection therapy, and peripheral retinal vascularization was completed. A second injection was required in 38 eyes. Rescue treatment was applied in addition to intravitreal ranibizumab treatment in 22 eyes of 11 babies. None of the patients had any ocular or systemic side effects. Low-dose intravitreal ranibizumab injection with close follow-up and appropriate timing is an effective treatment modality in A-ROP. Even among patients undergoing rescue laser treatment, the treatment can be completed with a wide visual field.
Highlights
Retinopathy of prematurity (ROP) is the most common cause of bilateral blindness in early infancy
Laser photocoagulation is applied as the gold standard treatment method in the treatment of ROP, its visual and anatomical results do not seem to be positive in severe diseases such as Aggressive posterior retinopathy of prematurity (APROP) seen in zone 1 and posterior zone 2 [6,7,8,9,10,11,12]
The aim of this study is to evaluate the efficacy of low-dose administration of 0.1 mg ranibizumab, an anti-vascular endothelial growth factor (VEGF) antibody fragment with a systemic half-life of hours, in the treatment of APROP
Summary
Retinopathy of prematurity (ROP) is the most common cause of bilateral blindness in early infancy. APROP, seen in zone 1 and posterior zone 2, may progress rapidly regardless of stage and result in retinal detachment and blindness unless diagnosed and treated early [2,3]. In the Early Treatment for Retinopathy Of Prematurity (ETROP) study, it was reported that poor outcomes may occur even if treated early [4]. Both physiological and pathological vascular processes in the retina are mediated by angiogenic growth factors, especially vascular endothelial growth factor (VEGF) [5]. Anti-VEGF treatments aiming to inactivate VEGF by blocking it in the vitreous have been widely applied
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