Abstract
Purpose: :
To evaluate the vascular changes after a single intravitreal injection of ranibizumab for threshold, pre-threshold and stage III ROP.
Methods: :
The study included six eyes from 3 patients with Stage III Plus disease ROP, one zone 2 and the other two zone 3. They were all treated with 0.025 ml intravitreal ranibizumab inyected at 1mm from limbus, the follow up was performed by indirect ophthalmoscopy, photography and wide angle fluorescein angiography with RetCam II.
Results: :
We found complete regression of neovascularization 3 days after injection, the rigde was flattened at two weeks, normal vasculature passed the ridge three weeks after injection and reached the ora at 6 weeks, tortuous vessels in one patient have not completely disappeared at 3 months of injection. We found no local or systemic adverse effects in a 3 months follow up.
Conclusions: :
Intravitreal ranibizumab may be an alternative in the treatment of ROP stage III, our findings sugest that antiangiogenic therapy may help lower the abnormal VEGF in vitreous in the stage III ROP allowing a down regulation that permits the normal development of vessels. Further studies with larger number of patients should be performed to asses our findings. This is the fist series reported using ranibizumab.
Clinical Trial: :
www.nih.gov NCT00346814
Keywords: retinopathy of prematurity • vascular endothelial growth factor • retinal neovascularization