Purchase this article with an account.
Kamiar Mireskandari, Megan Collins, Nasrin Najm-Tehrani; Anti-VEGF Agents in Retinopathy of Prematurity (ROP): Results of a Utilization Survey and Recommendations for the Consent Process. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5856.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Anti-vascular endothelial growth factor (VEGF) agents represent a promising new treatment option for ROP. We developed a web-based survey for ROP practitioners in the United States and Canada to obtain information about whether ophthalmologists were using anti-VEGF agents in their ROP practice, details of the administration protocol and how they were addressing consent and parental education. Based on the information collected in this survey, we have developed recommendations for the informed consent process.
The survey was distributed to 2479 pediatric ophthalmologists and vitreoretinal specialists in the US and Canada. Those who acknowledged participation in the screening and/or treatment of ROP were annonymously surveyed regarding their clinical experience with anti-VEGF agents, as well as their institutional guidelines for using anti-VEGF in children and the consent process.
Approximately 20% of ophthalmologists manage ROP and we anticipated a proportional response rate. A total of 212 respondents (125 pediatric ophthalmologists and 87 vitreoretinal specialists) completed the survey. Anti-VEGF agents were used by 35.8% of respondents, with the majority (72.5%) reporting experience in less than 5 eyes. Most practitioners had used anti-VEGF agents as first line treatment in select cases as determined by the severity of ROP or patient considerations, i.e. medically unstable or diffcult view and 28.9% reported having a treatment failure or recurrence after using anti-VEGF agents. The majority of respondents (77.6%) did not have an institional policy for the use of anti-VEGF agents in ROP. The four elements most frequently included in the consent process were its off-label status (83%), unknown long-term data (80%) with anti-VEGF agents in children, personal experience with anti-VEGF (57%) and published data from the BEAT-ROP study (53%). Pediatric ophthalmologists divulged more information whilst consenting compared to retina specialists.
This is the first large-scale survey to report on the current use of anti-VEGF to treat ROP. Only a few institutions had guidelines regarding the use of anti-VEGF in ROP. Based on the survey results, we have developed consent and educational guidelines that may be utilized by ROP practitioners.
This PDF is available to Subscribers Only