A Network Meta-Analysis of Retreatment Rates following Bevacizumab, Ranibizumab, Aflibercept, and Laser for Retinopathy of Prematurity

Chang, Emer; Josan, Amandeep S.; Purohit, Ravi; Patel, Chetan K.

doi:10.1016/j.ophtha.2022.06.042

Cited by 42 publications

(27 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Important in that regard is that ranibizumab, other than bevacizumab, has a very short systemic half‐life, thus limiting systemic exposure of treated infants 45,48 . When comparing the current ROP treatment options available, a comparative meta‐analysis revealed a single‐treatment success rate of 89% for laser, 87% for bevacizumab, 81% for aflibercept, and 74% for ranibizumab 49 . However, for zone I ROP, success was better for bevacizumab (91%) and ranibizumab (78%) than for laser (66%).…”

Section: Interventionmentioning

confidence: 99%

Retinopathy of prematurity

Dammann

Hartnett

Stahl

2022

Develop Med Child Neuro

View full text Add to dashboard Cite

Despite momentous improvements in perinatal care over the past few decades, retinopathy of prematurity (ROP) remains an interdisciplinary challenge for neonatologists and pediatric ophthalmologists. In the USA, treatment-warranted ROP increased from 3.4% to 5.3% between 2009 and 2018 among infants of 30 weeks gestation or less at birth. 1 In the international Vermont Oxford Network data, the median prevalence of severe ROP declined from 9% in 2005 to 6% in 2011, but has not further declined during the years 2011 to 2014. 2 In 2010, an estimated 185 000 infants born preterm developed any ROP and 20 000 subsequently suffered severe visual impairment or blindness. 3 In this review, our goal is to provide an overview of recent developments in our thinking about etiology, pathogenesis, diagnosis, intervention, and outcomes of ROP. Our aim is not to give an exhaustive overview, but to concentrate on novel ideas and findings. Reference to previous reviews is made where appropriate.The incidence of ROP decreases with increasing gestational age at birth, and it occurs mainly, but not exclusively, among infants born extremely preterm (<28 weeks gestational age) in high-income countries. A 'third epidemic' of ROP, however, is ongoing in low-and middle-income countries; here, the majority of infants with severe ROP appear to be more than 29 weeks gestational age. 4 [Correction added on 5 December 2022 after first online publication: In the sentence ''A 'third epidemic' … be more than 29 weeks gestational age'', the word 'less' was updated to 'more'.] The phenotype and disease trajectory in these more mature infants differ appreciably from that in infants born extremely preterm, which comes with its own set of difficulties regarding screening and intervention.ROP is a developmental disorder in that the clinical picture changes over the course of the neonatal and postneonatal periods. In essence, the underlying developmental process of typical retinal vascularization is affected in different ways at different time-points. 5 Clinically, the predominant feature of the disorder is abnormal retinal vascular development, beginning with a first phase of retinal vessel development cessation or delay shortly after birth that is exacerbated during the ensuing

show abstract

Section: Interventionmentioning

confidence: 99%

Retinopathy of prematurity

Dammann

Hartnett

Stahl

2022

Develop Med Child Neuro

View full text Add to dashboard Cite

show abstract

“…In the RAINBOW study 11 , 22 eyes (15%) in the ranibizumab 0.2 mg group and 26 eyes (17%) in the ranibizumab 0.1 mg group received additional treatment due to ROP recurrence. The RAINBOW study 6 recommends the use of 0.2 mg ranibizumab, but in real-world settings, ranibizumab is used in various doses from 0.15 mg to 0.3 mg 11,15,20 . A US multicenter study 15 found no signi cant difference in the retreatment rate between the low-dose and high-dose ranibizumab groups.…”

Section: Resultsmentioning

confidence: 99%

Characteristics of retinal vascularization in reactivated retinopathy of prematurity and clinical outcome after reinjection of ranibizumab

Jang

2024

Preprint

View full text Add to dashboard Cite

This study aimed to determine whether the state of retinal vascularization after anti-vascular endothelial growth factor (anti-VEGF) injection can help predict the risk of recurrence of retinopathy of prematurity (ROP) and whether repeated injection treatment will be effective in case of recurrence. We retrospectively reviewed 24 infants (43 eyes) who received ranibizumab monotherapy between January 2021 and December 2022. All eyes were classified as having non-reactivated ROP or reactivated ROP. The state of ROP at the time of treatment, the time required for resolution of plus disease, and the extent of vascularization at 4 and 8 weeks after treatment were analyzed. Extent of retinal vascularization was measured with serial RETCAM™ fundus images using disc-fovea distance (DF) unit. ROP reactivation occurred in six infants (25.0%) and ten eyes (23.3%) after ranibizumab treatment. The mean reactivation interval after the initial injection was 9.0 ± 3.3 weeks (range 4–16). In the reactivated ROP group, the time required for the resolution of plus disease after injection was longer compared to the control group (13.3 days vs 5.2 days), with a mean ROP regression time of 3.4 weeks. All eyes in the reactivated ROP showed retinal vascularization < 0.5 DF from the original site at 4 weeks after injection. In 90% of cases with reactivated ROP, the extent of vascularization at 8 weeks after injection was within 1 DF from the original ROP site, and all cases showed reactivation 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. The continuation of delayed retinal blood vessel development after ≥ 8 weeks may indicate a high likelihood of ROP recurrence. In the absence of vitreous traction, ranibizumab reinjection is likely to be effective in treating ROP recurrence.

show abstract

“…Most studies reported an overall higher rate of retreatment for ROP cases with IVI compared to laser therapy, particularly for the zone 2 disease; 13 14 whereas the rate of retreatment was lower with IVI than laser in zone 1 ROP. 14 The indications of retreatment could be due to initial failure of IVI, recurrence of the disease, or persistence of the PAR. The characteristics of different indications for retreatment after IVI for type 1 ROP are summarized in Table 1 .…”

Section: R Esultsmentioning

confidence: 99%

“… 18 In addition to the patient factors, the type of anti-VEGF (IVR > IVB) and lower injected doses may also increase the risk of recurrence (without compromising the initial response). 14 21 …”

Section: R Esultsmentioning

confidence: 99%

An Update on Anti-Vascular Endothelial Growth Factor Treatment for Retinopathy of Prematurity

Nowroozzadeh,

Sadeghi,

Shahriari-Garaee

et al. 2023

Journal of Current Ophthalmology

View full text Add to dashboard Cite

Purpose: To present updated information on the role of anti-vascular endothelial growth factor (anti-VEGF) therapy for treating retinopathy of prematurity (ROP). Methods: We searched through PubMed and Scopus databases using the keywords of this article and gathered relevant published articles from the year 2005 to December 2022. The selected articles were classified and summarized, and reasonable conclusions were made accordingly. Results: Considering the current evidence, anti-VEGF agents are superior to laser therapy for the initial treatment of type 1 ROP in zone 1 or posterior zone 2. However, there is a substantial risk of reactivation or persistent avascular retina after solo treatment with anti-VEGFs, and many cases may require laser therapy within the following weeks or months. Thus, vigilant follow-up examinations are mandatory. Conclusions: The role of anti-VEGF agents in the treatment of ROP is indispensable. However, future studies are required to improve indications and dosage and determine long-term ocular and systemic safety.

show abstract

A Network Meta-Analysis of Retreatment Rates following Bevacizumab, Ranibizumab, Aflibercept, and Laser for Retinopathy of Prematurity

Cited by 42 publications

References 67 publications

Retinopathy of prematurity

Retinopathy of prematurity

Characteristics of retinal vascularization in reactivated retinopathy of prematurity and clinical outcome after reinjection of ranibizumab

An Update on Anti-Vascular Endothelial Growth Factor Treatment for Retinopathy of Prematurity

Contact Info

Product

Resources

About