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Martin Guzman-Sanchez, Veronica Giordano, Samantha Salinas Longoria, Rafael Romero Vera, Guillermo Salcedo-Villanueva, Virgilio Morales-Canton, Hugo Quiroz-Mercado, Maria Martinez-Castellanos; Macular Morphology Before and After Intravitreal Bevacizumab in Patients with Retinopathy of Prematurity: A Spectral Domain Ocular Coherence Tomography Comparative Case Series. Invest. Ophthalmol. Vis. Sci. 2013;54(15):622.
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The purpose of this study is to describe macular changes with spectral domain ocular coherence tomography (SD-OCT) in preterm patients with retinopathy of prematurity before and after administration of intravitreal Bevacizumab (Avastin).
We evaluated 6 preterm infants (mean 28 weeks of gestation) who arrived to the Retina department of our hospital with clinical diagnosis of ROP. SD-OCT scan, Fluorescein angiography with RetCam imaging was performed at patient arrival and post-administration of a single dose of Bevacizumab (Avastin, 0.625 mg).
A total of 10 eyes were evaluated. Two experts assessed separately RetCam and SD-OCT images in order to reach consensus. 2 eyes were classified as threshold disease, 4 with type 1 ROP and 4 with type 2 ROP, clinically and angiographically. The SD-OCT scan revealed “pattern B” macular morphology (multiple confluent or nearly confluent, vacuolated, optically empty or hyporeflective spaces within the layers of the retina with an almost normal foveal depression) in all cases; with poor differentiation of the internal retinal layers (IRL) in one eye and absence of foveal depression in another eye. A new SD-OCT and RetCam study was taken a mean of 4 weeks after the injection. In all cases, neovascularization, vessel tortuosity regressed and progression of retina vascularization beyond zone 2 was observed. The new SD-OCT scan revealed reduction of the cystic spaces or no change in pattern B and refinement of the foveal depression although persistence of IRL on the foveal zone in all of the eyes, but presence of epiretinal membrane in four eyes which did not have it previously.
SD-OCT can be a useful tool to accurately classify and follow retinopathy of prematurity. Although further findings remain to be done, there is almost insignificant architectural changes (as observed in SD-OCT scans) in the macula of patients with ROP after Bevacizumab intravitreal therapy. To our knowledge, this is the first study to report macular changes of ROP patients after intravitreal Bevacizumab therapy.
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