Abstract
Purpose :
Anti-VEGF therapy for zone I and posterior zone II retinopathy of prematurity (ROP) offers the potential for continued retinal vascular development, resulting in a relative preservation of visual fields. However, anti-VEGF monotherapy is associated with a risk of late ROP recurrences. We aimed to determine the ophthalmic outcomes of treatment with intravitreal ranibizumab followed 4-6 weeks later by planned laser photocoagulation for zone I or posterior zone II stage 3 with plus ROP.
Methods :
We conducted a retrospective consecutive case series of 36 eyes of 18 infants with zone I or posterior zone II ROP stage 3 with plus disease that were treated with intravitreal ranibizumab (0.25 mg/0.025 ml) followed 4-6 weeks later by laser photocoagulation. The patients were treated and followed over a 2 year period in a tertiary referral-based hospital. The primary outcome was recurrence of retinopathy of prematurity in one or both eyes requiring retreatment. The mean postmenstrual age at the last ROP follow-up was 64 weeks.
Results :
The mean gestational age at birth of the patients in our case series was 24.7 ± 1.5 weeks and the mean birth weight was 652.3 ± 115.1 grams. Treatment with intravitreal ranibizumab for stage 3 with plus ROP was administered at a mean postmenstrual age of 37.1 ± 2.3 weeks. Planned laser photocoagulation was administered in all cases at a mean postmenstrual age of 42.6 ± 2.5 weeks. No eyes had ROP recurrences requiring further intervention in the follow-up period up to a mean of 64 weeks postmenstrual age. Nine of 36 eyes (25%) developed myopia and 2 of 18 patients (11.1%) were diagnosed with strabismus during the follow-up period.
Conclusions :
Combination treatment with intravitreal ranibizumab and delayed laser photocoagulation is effective for zone I or posterior zone II stage 3 with plus ROP.
This is a 2020 ARVO Annual Meeting abstract.