Purchase this article with an account.
Yoshihiro Yonekawa, Benjamin J Thomas, Robison Vernon Paul Chan, Kimberly A Drenser, Michael Thomas Trese, Antonio Capone; Retinal Detachments after Intravitreal Anti-VEGF Injections for Retinopathy of Prematurity. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):982.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To characterize retinal detachments that developed after intravitreal anti-VEGF treatment for retinopathy of prematurity (ROP).
This is a retrospective, interventional, non-comparative series from two tertiary referral practices for pediatric vitreoretinal diseases. Clinical histories and characterization of the retinal detachment are reported, from patients who developed retinal detachment after intravitreal anti-VEGF treatment for ROP.
Thirteen eyes from 8 infants were included in the study. Median gestational age was 24 weeks (range 23-27), and median birth weight was 749 grams (range 430-1180). All patients had been diagnosed with aggressive posterior ROP at the time of anti-VEGF injection. Seven (88%) infants were treated with half-dose bevacizumab, and 1 with half-dose ranibizumab. The injections occurred at a median post-menstrual age (PMA) of 35 weeks (range 33-38). Photocoagulation was provided before or after the injection in all except one patient. Twelve (92%) eyes demonstrated a progressive tractional retinal detachment, akin to the “crunch” phenomenon of contractile fibrovascular tissue after anti-VEGF treatment. The circumferential tractional vectors were more exaggerated compared to conventional ROP detachments in 10 (83%) eyes. Twelve (92%) eyes progressed to stage 4B or 5, and 10 (77%) underwent various vitreoretinal surgeries, after which the posterior pole and/or peripheral retina was attached in 8 (80%) intervened cases. One patient who was injected relatively earlier at 34 weeks PMA developed a severe and long-lasting effusive detachment, which was noted 1 month after the injection. Median follow-up time was 20 weeks after the anti-VEGF injections.
Intravitreal anti-VEGF treatment for ROP may lead to a progressive atypical tractional retinal detachment caused by a “crunch” phenomenon, or to a severe effusive retinal detachment.
This PDF is available to Subscribers Only