Abstract
Purpose :
To determine the retinal vascularization characteristics of reactivated retinopathy of prematurity (ROP) after intravitreal ranibizumab monotherapy and to evaluate the outcome after ranibizumab reinjection for the treatment of reactivation.
Methods :
We retrospectively reviewed twenty-four infants (43 eyes) who received ranibizumab monotherapy between January 2021 and December 2022. All eyes were classified as having nonreactivated ROP or reactivated ROP. Data on the stat of ROP at the time of treatment, duration of plus disease disappearance, extent of vascularization of 4, 8 weeks after treatment were collected and analyzed. In reactivated ROP cases, the reactivation interval, reactivated ROP state, re-treatment timing, and results after reinjection of ranibizumab were investigated.
Results :
ROP reactivation occurred in six infants (25%) and ten eyes (23.3 %) among ROP infants treated with ranibizumb. The reactivation interval was an average of 9.0 ± 2.1 weeks (range 4 -16 weeks) after initial injection. In reactivated ROP groups, it took longer for the plus disease disappearance after injection compared the control group ( 5.2 days vs. 13.3 days), with ROP regression taking an average of 3.4 weeks. In most cases of reactivated ROP, the extent of vascularization at 8 weeks after injection was within 1 disc diameter of the lesion, and all were reactivated in the posterior Zone II area. After ranibizumab retreatment, only one reactivated case with vitreous traction progressed to focal retinal detachment, while all other cases regressed with peripheral vascular development.
Conclusions :
Reactivation can occur well if delayed retinal vascular development persist even after more than 8 weeks of treatment. At this time, if there is no vitreous traction, re-injection of ranibizumab is considered effective for regression.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.