Abstract
Purpose :
Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are increasingly being used for treatment-warranted retinopathy of prematurity (TW-ROP). Some prior authors have reported abnormal fluorescein angiography (FA) findings, including persistence of peripheral avascular retina, in infants with TW-ROP following treatment with intravitreal bevacizumab (IVB). We therefore hypothesize that in infants who have received IVB, FA images will demonstrate vascular abnormalities.
Methods :
A retrospective review of infants with TW-ROP who received IVB and subsequently underwent FA at Wake Forest Baptist Medical Center between 2013 and 2019. Clinical data was collected for each qualifying eye and morphologic characteristics of each FA were recorded.
Results :
FA was evaluated for 44 eyes of 23 infants. Average gestational age (GA) was 24.1 weeks and average birth weight was 580 grams. All eyes had persistent avascular retina on FA. Angiographic recurrence of ROP was present in 21/44 (48%) eyes. Absence of foveal avascular zone was noted in 12/40 (30%) eyes. Vascular tortuosity was noted in 25/42 (60%) eyes. Shunt vessels were present in 35/42 (83%) eyes, and diffuse vascular leakage was noted in 6/43 (14%) eyes. Vascular straightening was noted in 6/44 (14%) eyes, and 1/44 (2%) eyes had retinal detachment.
Conclusions :
This descriptive study cannot address whether the FA features present are directly related to prior IVB treatment. Although the clinical implications of these FA features are not known, the presence of avascular retina in all eyes and high percentage of recurrent ROP post-IVB does have implications for continued screening after IVB for ROP and potentially for the use of adjunct laser photocoagulation to prevent late recurrence. Further investigation is needed to fully elucidate the long-term ocular effects of IVB in infants with TW-ROP.
This is a 2020 ARVO Annual Meeting abstract.