Abstract
Purpose :
Anti-VEGF intravitreal injections of Bevacizumab (IVB) and laser photocoagulation are effective treatments for Retinopathy of Prematurity (ROP), a preventable blindness in premature infants. Fluroescein angiogragphy (FA) is used with color fundus photography to visualize retinal vasculature. We performed a retrospective cliniclal review to analyze the FA changes in infants with ROP after bevacizumab injections and/or laser photocoagulation and noted the rate of recurrence of ROP.
Methods :
Premature infants in the NICU at the University of Florida (UF) Shands Hospital between January 2012 and January 2023 were treated for ROP with 0.625mg;0.025ml/eye IVB. 7mg/kg-10mg/kg of fluorescein was given in the operating room under anesthesia to note the zone and vascular changes on FA.
Results :
One hundred and twelve eyes of 60 premature infants were reviewed, 34 females and 26 males. The first IVB was given earlier in infants with recurrence than in infants without recurrence (33 vs 34.86 postmenstural age in weeks). The recurrence incidence was 28.6% (32/112 eyes) and the average time of recurrence was 8.68 weeks ± 4.24 weeks. On FA, we noted straight vessels were seen in infants without recurrence (11.3%, 9/80 eyes). We also noted that new vessels (21.9%, 7/32 eyes), and vessel leakage (43.8%, 14/32 eyes) were seen in infants with recurrence. Loop vessels at the border (25.9%, 29/112 eyes), sea fan shaped vessels (18.8%, 21/112 eyes), a border with telangiectasia and shunts (16.1%, 18/112 eyes), tufts (15.2%, 17/112 eyes), tortuosity (10.7%, 12/112 eyes), and popcorning of vessels (10.7%, 12/112 eyes), were seen in both groups of infants with recurrence and without recurrence.
Conclusions :
Our study demonstrates that retinopathy of prematurity results in retina vascular abnormalities in infants with or without recurrence. There were common FA changes noted amongst infants in both groups after IVB and/or laser photocoagulation. There were some sole changes but in many infants there were multiple changes noted. Retinopathy of prematuirty requires follow up care and treament in order to prevent retinal detachment and blindness.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.