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Birgit Lorenz, Marie Neumann, Monika Andrassi-Darida, Melanie Jäger, Knut Stieger; Comparison of transpupillary laser versus intravitreal bevacizumab treatment in posterior zone II ROP. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6273. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To report the outcome of laser treatment in acute retinopathy of prematurity (ROP) in posterior zone II, to compare it to treatment with intravitreal 0.312mg bevacizumab (IVB) and to describe the vascular development over time.
In this retrospective study, 25 infants with ROP stage 3+ in posterior zone II, who were treated between August 2009 and August 2015 either by transpupillary laser photocoagulation performed with a diode laser (Ocu-Light SL, Iridex Corp) and a 20 or 28 dpt lens (Volk Optical Inc) in a near confluent technique (exposure time: 100-150ms, power: 200-500mW) (n=20, 40 eyes) or by IVB (n=5, 10 eyes) were included. Infants were examined by digital fundus photography and fluorescein angiography (FA) using a Shuttle, RetCam II or III (Clarity Inc.) before and after treatment.
Mean gestational age was 25.2w ± 10d and 24.3w ± 4d, and mean birth weight, 659 ± 183g and 653 ± 90g for the laser treated and the IVB group, respectively. Mean time to treatment was 12.5w ± 16d and 10.7w ± 6d, respectively. Acute ROP regressed in all eyes (100%) treated by a single IVB, but only in 75% of eyes with one laser treatment. Mean time to retreatment was 4.4 weeks after first treatment, and included repeated laser photocoagulation (1 infant o.u.), cryo-coagulation (3 infants o.u.) and IVB (1 infant o.u.). Repeated rescue treatments were necessary in 2 infants /4 eyes. No eye developed cataract or macular dragging. The overall success rate in the laser treated group was also 100%. Before treatment, most eyes showed leakage at the junction of the vascularized zone and capillary malformation. Vessel outgrowth into the periphery was observed in IVB treated eyes as well as in laser treated eyes, where the vessels continued to grow over the laser scars.
A single intravitreal dose of 0.312mg/eye bevacizumab was sufficient to induce regression of ROP in posterior zone II, in contrast to laser treatment, where 5 infants (10 eyes, 25%) needed at least one further treatment.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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