Abstract
Purpose :
To quantify the laser burn spots to the avascular retina (PAR) in infants post intravitreal bevacizumab (IVB) injection for retinopathy of prematurity (ROP) at different age groups.
Methods :
An observational, longitudinal clinical study of 142 eyes of 71 infants treated with laser photocoagulation to PAR for type-1 ROP post IVB (0.75mg/0.03ml). The laser burn spots, power, duration, and interval to the PAR were noted from 4 groups. Group 1 and 2 infants had zone 1 and zone 2 ROP respectively who received laser < 60 weeks post-menstrual age (PMA). Group 3 received laser at > 61 weeks PMA until one-year chronological age and Group 4 received laser post one year of chronological age until three years of age.
Results :
Mean GA and birth weight BW was 25 weeks PMA and 727 grams. 134 eyes had type 1 ROP, and 8 eyes aggressive posterior ROP, of which 82 eyes had zone 1 and 60 eyes had zone 2 ROP at first treatment. 63 infants received IVB prior to laser. The average age at laser for Group 1 and 2 was 42 weeks PMA; group 3, 71 weeks PMA and group 4, 25 months. The average laser spots in right/left eye in group 1 were 2817/2019; group 2, 2242/2274; group 3, 2139/1756 and group 4, 1255/1218 resp. Nonparametric test was used to compare laser shots in right and left eye performed in gr1 and gr2 at < 60 weeks PMA and gr 4 >one year of age was statistically significant (p<0.0001).
Conclusions :
Delaying laser beyond one year of age when treated with standard dosage of IVB (0.625 to 0.75 mg) to PAR decreases the total laser shots given significantly thereby decreasing risk of immediate complications like choroidal/retinal detachments, macular changes and long-term effects of high myopia, anisometropia, amblyopia and visual compromise.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.