Abstract
Purpose :
Retinopathy of prematurity (ROP) is a leading cause of blindness in children in the US. It involves development of neovascularization in premature infants and can lead to retinal detachment and blindness. Treatment involves prevention of retinal detachment and has evolved from full-thickness cryotherapy to laser ablation. More recently, physicians have employed anti-VEGF agents, such as intravitreal bevacizumab (IVB), based on the pathophysiology of the disease and evidence from the BEAT-ROP and RAINBOW studies. However, there is a need for data on how these treatments influence the timing of the disease and monitoring recommendations in patients with ROP. This study investigates the outcomes of infants with ROP treated with IVB, including average time to complete revascularization and to subsequent laser therapy.
Methods :
A retrospective, hospital-based study. Infants who met threshold for treatment and received IVB between 2018 and 2021 were included (n=20). Patients were monitored from their first ROP screening exam until complete revascularization or laser therapy. Age, weight, and risk factors for treatment were also analyzed.
Results :
Patients had an average birth weight of 702 grams and average gestational age at birth of 24.8 weeks. Patients received IVB at an average post-menstrual age (PMA) of 37.1 weeks. 30% (n=6) of patients had disease regression and subsequent complete vascularization and did not require laser treatment. 35% (n=7) required laser for recurrence of ROP. 35% (n=7) required laser treatment for persistent avascular retina. Of those who fully vascularized without laser treatment, close monitoring was stopped at an average PMA of 51.2 weeks, or 18.9 weeks after IVB. Disease recurrence occurred at average PMA of 49.5 weeks, or 13.4 weeks after IVB. Laser for avascular retina occurred at average PMA of 60.9 weeks, or 25.6 weeks after IVB.
Conclusions :
This study offers insight into the timing and management of ROP after IVB. Approximately one third of patients will develop recurrence of ROP following injection, and patients need to be followed up to PMA of 60 weeks to monitor for recurrence and to decide on need for laser treatment.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.