PURPOSE:The purpose of the study was to evaluate the long-term efficacy and safety of intravitreal bevacizumab (IVB) in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks (AS).MATERIALS AND METHODS:Noncomparative, interventional retrospective case series involving ten patients (15 eyes) with a minimum follow-up of 25 months following IVB for AS-associated CNV. Demographic and clinical details at baseline and during follow-up were collected from patient records. Detailed clinical examination was followed by fundus fluorescein angiography and optical coherence tomography to confirm CNV. Both primary and recurrent CNVs were treated with monthly injections of IVB till the lesion stabilized. Primary outcome measures were the percentage of patients with stable or improved visual acuity (VA) and with stable or decreased central retinal thickness (CRT) at the last visit. Secondary outcome measure was the incidence of ocular and systemic complications.RESULTS:Recurrence was observed in 11 eyes (73.33%) over a mean follow-up of 57.33 months (range: 25–100). A mean number of injections administered was 5.60. VA improved or stabilized in 73.33% and deteriorated in 26.67% of eyes at the final visit. Mean CRT improved from 324.40 μm at baseline to 265.53 μm at final visit, which was statistically significant. Complications observed were ocular hypertension in one patient and thromboembolic event in another patient.CONCLUSIONS:IVB appears to be a safe and effective option to treat CNV and to preserve vision over a prolonged period. It cannot eliminate the risk of recurrent CNV indicating the need for more effective treatments to arrest this visually debilitating condition.

Background: Retinopathy of Prematurity (ROP) is a multifactorial vasoproliferative retinal disorder that increases in incidence with gestational age. ROP is a vascular retinal disease that can cause low vision or blindness. ROP is a common blinding disease in children which is becoming increasingly prevalent in the developing world. Aim: The aim of this study is to evaluate the incidence of Retinopathy of prematurity (ROP) and its association with risk factors such as low birth weight, gestational age, oxygen therapy, respiratory distress syndrome and sepsis among premature infants admitted to the Neonatal Intensive Care Unit (NICU) of Krishna Institute of Medical Sciences, Karad. Methods: Retrospective chart review of all infants admitted to the NICU between July 2017 and July 2019, who met the criteria for ROP screening: (a) ≤32 weeks of gestation, (b) ≤1.500 kg of birth weight, (c) infants with significant risk factors including sepsis, respiratory distress syndrome, or long-term oxygen use. Treatment was offered to infants with Stage III ROP disease or Stage II in Zone II with plus disease. Qualified infants were treated with argon laser photocoagulation within 48 h of diagnosis. Results : A total of 233 neonates who met the criteria were screened for ROP. Incidence of ROP was found to be 35.62% among the babies screened (n=83) majority of whom had stage 1 ROP (83.13%). Maximum incidence was seen in neonates of gestational age between 32-35 weeks (54.22%) and neonates of birth weight between 0.750 and 1.500 kg (85.54%). Other prevalent risk factors for development of ROP include Respiratory Distress Syndrome (59%) and Oxygen therapy (65%). Four neonates were found with plus disease and six neonates required laser treatment. Conclusion: The present study reflects the problem of ROP in a tertiary care centre. Prematurity, Low Birth Weight (LBW), high oxygen supplementation, respiratory distress syndrome were found to be independent risk factors in the development of ROP in neonates. Because of advancements in neonatal intensive care in developing countries and higher survival rate of premature infants, the incidence of ROP has increased. Unrecognized and untreated ROP will cause potential blindness in children. Hence, to prevent the adverse visual outcome and possible blindness; timely screening, recognition, and treatment of ROP is essential.

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