Abstract
Purpose :
Anti-Vascular Endothelial Growth Factor (Anti-VEGF) agents have revolutionized the treatment of many diseases in ophthalmology, and have begun to find increased use in the treatment of Retinopathy of Prematurity (ROP). Although the use of Anti-VEGF agents has demonstrated benefits in severe (i.e., Type 1) ROP, many questions remain about its optimal use and long-term outcomes. Here, we investigate the need for multiple Anti-VEGF injections and factors which may predict a reduced response to treatment requiring repeat therapy for ROP.
Methods :
Retrospective chart review study of patients screened for ROP as inpatients in the Neonatal Intensive Care Unit (NICU) between 2011-2021 who also received anti-VEGF treatment. Electronic medical records were used to obtain patient demographics as well as ophthalmic and non-ophthalmic treatments and outcomes. Patients were stratified by whether they received single or multiple anti-VEGF injections.
Results :
32 patients (59 eyes) were identified as receiving at least one injection, and 5 patients (8 eyes) receiving two injections. The mean post-menstrual age of those receiving a single injection was 24.6 weeks [range:22.1-31.7] and for two injections was 23.8 weeks [range:23.3-25.7]. Receiving multiple injections was not correlated with birthweight (p=0.121) or gestational age (p=0.14), but was associated with decreased age at first injection (OR = 0.31-0.82; p=0.006). The mean corrected gestational age at first injection for those receiving a single injection was 36.3 weeks [range:31.5-47.4] and for two injections was 33.1 weeks [range:31-36.6]. Age at first injection was not significantly correlated with gestational age (R2 = 0.281) or birth weight (R2=0.062).
Conclusions :
Infants with severe ROP requiring anti-VEGF treatment at earlier ages may be more likely to require repeat therapy at later ages. This data may be helpful when counselling parents during initial treatment discussions, and highlights the importance of close follow-up of these patients to assess the need for additional treatment.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.