Anti-VEGF treatment efficacy for aggressive posterior retinopathy of prematurity

Abstract

Purpose. To evaluate the anti-VEGF therapy efficacy for treatment aggressive posterior retinopathy of prematurity (AP-ROP). Material and methods. 14 children (28 eyes) with APROP, mean gestational age of 27.4 weeks. Birth weight were from 480 to 1360 grams, on average – 972.8 grams. AP-ROP were developed children post-conceptual age (PCA) from 31 to 34 weeks, with an average of 32.2 weeks. Intravitreal injection of ranibizumab was performed no later than one day after the detection of AP-ROP. Results. In 22 (78.5 %) of 28 eyes, only one injection of ranibizumab was required, of which, in 6 eyes, additional laser photocoagulation of the retina was performed after the injection in a period of 14 to 21 days. In the remaining 6 eyes (21.5 %), 2 injections of ranibizumab were required 4 to 8 weeks after the first injection. All 34 injections were completed without complications and were not accompanied by any adverse events in the treated children. Retinal detachment developed in 2 children in 3 eyes (10.7 %): in one child – in both eyes (stage 4A ROP – in one of the eyes, 4B – in the paired one); the second child has stage 4B ROP in one of the eyes. All children after anti-VEGF therapy had not complete fundus vascularization to 65 weeks of PCA. As a rule, the 3rd zone of the fundus remained avascular, but no signs of angiogenesis were observed, which we regarded as regression of disease without complete retinal vascularization. Conclusion. The efficacy of treatment of AP-ROP with anti-VEGF therapy was high and amounted to 89.3 %. In 78.5% of cases, one injection of ranibizumab is sufficient for regression of disease. Given the absence of complete retinal vascularization at 65 weeks of PCA, children undergoing anti-VEGF therapy require longer follow-up due to the possibility of reactivation of ROP later in PCA. Keywords: aggressive posterior retinopathy of prematurity, anti-VEGF therapy