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Parisa Emami-naeini; Intravitreal Anti-Vascular Endothelial Growth Factor inhibitors in Treatment of Retinopathy of Prematurity: Systematic Review. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5923.
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To evaluate the extent and quality of evidence on off label use of various anti vascular endothelial growth factors (anti-VEGF) in the treatment of retinopathy of prematurity (ROP)
A systematic review of the current literature indexed between January 1, 2009 to December 1, 2013 in CENTRAL (Cochrane central register for controlled trials), Ovid MEDLINE, clinicaltrials.gov (www.clinicaltrials.gov), PubMed and EMBASE was performed. All case series/reports, retrospective and prospective studies on the use of different anti-VEGF agents in ROP were included.
A total of 22 studies reporting on 646 eyes of 424 patients met the search criteria and were included in this review. They consisted of two randomized clinical trials (RCT), two retrospective case-control studies, fourteen case-series (eleven retrospective, 3 prospective) and four case-reports. Anti-VEGF agents used included bevacizumab (in 486 eyes), pegaptanib (in 152 eyes) and ranibizumab (in 8 eyes). All except for one study noted a general improvement in the retinopathy. Complications included vitreous and preretinal hemorrhage, cataract, vitreous organization and exotropia.
General body of evidence suggests that anti-VEGFs (alone or in adjunct with laser treatment) are effective in treating ROP. However, most of the current literature consists of retrospective studies. Well-designed randomized trials with long-term follow up are needed for further evaluation of the efficacy of these agents.
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