July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Fluorescein angiography findings post intravitreal bevacizumab for Retinopathy of Prematurity: Can it predict the late-onset risk of recurrence?
Author Affiliations & Notes
  • Swati Agarwal-Sinha
    Department of Ophthalmology, , University of Florida, Gainesville, Florida, United States
  • Andres Gonzales
    Department of Ophthalmology, , University of Florida, Gainesville, Florida, United States
  • Footnotes
    Commercial Relationships   Swati Agarwal-Sinha, None; Andres Gonzales, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2746. doi:
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      Swati Agarwal-Sinha, Andres Gonzales; Fluorescein angiography findings post intravitreal bevacizumab for Retinopathy of Prematurity: Can it predict the late-onset risk of recurrence?. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2746.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Fluorescein angiography (FA) use has documented the retinal vascular changes seen in eyes treated with Intravitreal bevacizumab (IVB) monotherapy for type 1 retinopathy of prematurity (ROP). We studied the retinal vasculature post IVB with FA and assessed the retinal findings imposing a risk for late complications.

Methods : We performed a retrospective, observational clinical study of 22 infants treated for type 1/aggressive posterior ROP (AP-ROP) with IVB monotherapy between 7/2014 to 11/ 2017. Data collection included gestational age (GA), birth weight (BW), postmenstrual age (PMA) at IVB treatment, recurrence of stage 3, number of examinations, adverse events from IVB, FA findings and retinal vascular growth until two years of age.

Results : Of the 22 infants treated with IVB monotherapy, all had eye examination with Retcam and FA performed at an average 70 weeks PMA. Of these, 11 infants had repeat FA at an average 98.73 weeks PMA and three infants at an average 130 weeks PMA. Average GA and BW was 24.6 weeks and 658 grams respectively. Average PMA at first IVB treatment was 37.5 weeks. 7 eyes of 5 infants received repeat IVB for recurrent stage 3 at an average 47.6 weeks. The average number of IVB treatments was 2. All 22 infants continued to show inhibited retinal vasculature in zone 2 with peripheral avascular retina. 19 of 22 infants had conventional FA findings which included avascular retina, peripheral leakage, shunts, abnormal vessels branching and tangles with no late complications noted until last examination performed. Only three infants showed unconventional FA findings showing significant posterior vascular tortuosity, extreme peripheral vascular branching, diffuse hyperfluorescence along the regressed proliferation site. Of the three infants only one had late peripheral tractional proliferation at 92 weeks PMA which was treated with local barrier laser with excellent visual preservation.

Conclusions : Unconventional FA findings seen post-IVB treatment in infants for ROP may need close long-term follow-up for early detection and treatment of late-onset sight threatening complications. A large prospective multicenter study would be beneficial in order to redefine current ROP follow-up examination guidelines post-IVB treatment.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

FA at 68 and 92 weeks PMA post repeat IVB for recurrent stage 3 ROP at 63 weeks PMA

FA at 68 and 92 weeks PMA post repeat IVB for recurrent stage 3 ROP at 63 weeks PMA

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