Korean J Ophthalmol.  2018 Dec;32(6):451-458. 10.3341/kjo.2018.0011.

Anti-vascular Endothelial Growth Factor Treatment of Retinopathy of Prematurity: Efficacy, Safety, and Anatomical Outcomes

• Kang HG
• Choi EY
• Byeon SH
• Kim SS
• Koh HJ
• Lee SC
• Kim M

• KMID: 2427959
• DOI: http://doi.org/10.3341/kjo.2018.0011

Abstract

PURPOSE
To investigate the efficacy, safety, and anatomical outcomes associated with intravitreal anti-vascular endothelial growth factor (VEGF) treatment of retinopathy of prematurity (ROP).
METHODS
We performed a retrospective review of intravitreal anti-VEGF (bevacizumab or ranibizumab) treatment of 153 eyes (83 infants) diagnosed with ROP at two tertiary hospitals from June 2011 to January 2017. The primary outcome was the rate of recurrence requiring additional treatment; secondary outcomes included incidence of major complications and final refractive error.
RESULTS
A total of 101 eyes were treated with bevacizumab, and 52 with ranibizumab. The bevacizumab and ranibizumab groups were characterized by mean birthweights of 941.8 ± 296.1 and 1,257.7 ± 514.5 g, gestational ages at birth of 26.9 ± 1.9 and 28.1 ± 3.2 weeks, and postmenstrual ages at treatment of 40.4 ± 2.4 and 39.2 ± 2.3 weeks, respectively. The two groups differed significantly in birthweights and gestational ages at birth, but not in postmenstrual ages at treatment. The mean follow-up duration was 30.9 ± 18.4 months for the bevacizumab group, and 13.9 ± 12.5 months for ranibizumab. More cases were classified as zone 1 ROP in the ranibizumab group (44.2% vs. 11.9%, p < 0.001). Major surgical interventions included scleral encircling and vitrectomy (one and two eyes, respectively, both in the bevacizumab group). Retinal detachment was noted in one eye treated with bevacizumab. There was no significant difference in the most recent spherical equivalence for the two groups (+0.10 ± 3.66 and +0.22 ± 3.00 diopters for bevacizumab and ranibizumab, respectively). Univariable analysis revealed that only ROP stage influenced the occurrence of major complications (odds ratio, 9.046; p = 0.012).
CONCLUSIONS
Intravitreal anti-VEGF treatment of ROP with both bevacizumab and ranibizumab achieved stable retinal vascularization with a low rate of complications and recurrence. Ranibizumab achieved similar anatomical outcomes as bevacizumab, without additional risk for major complications.

Keyword

Bevacizumab; Intravitreal injections; Ranibizumab; Retinopathy of prematurity

MeSH Terms

Bevacizumab
Endothelial Growth Factors*
Follow-Up Studies
Gestational Age
Incidence
Intravitreal Injections
Parturition
Ranibizumab
Recurrence
Refractive Errors
Retinal Detachment
Retinaldehyde
Retinopathy of Prematurity*
Retrospective Studies
Tertiary Care Centers
Vitrectomy
Bevacizumab
Endothelial Growth Factors
Ranibizumab
Retinaldehyde

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