Atypical case of retinopathy of prematurity with candle wax-like preretinal deposits and its surprising response to intravitreal antivascular endothelial growth factor

Shah, Miloni; Padhy, Srikanta Kumar; Sahu, Suman; Padhi, Tapas Ranjan

doi:10.1136/bcr-2021-244998

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Often, the vessels in very posterior ROP are thin, and the vascular-avascular junction can be difficult to appreciate. 27 Our data did not allow us to compare primary treatment with intravitreal anti-VEGF and laser, given the inequality in the treated eyes (99 eyes: anti-VEGF and 10 eyes: laser). Many investigators 1,5,7,9 have shown that laser as the initial treatment for ROP in this posterior Zone I had a higher risk of treatment failure (Table 4).…”

Section: Discussionmentioning

confidence: 91%

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Outcome of eyes treated for Retinopathy of Prematurity in Posterior Zone I: An Eastern India study.

Padhi,

Bhunia,

Shah

et al. 2024

Retina

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Purpose: To analyze the outcomes of eyes treated for retinopathy of prematurity (ROP) in posterior Zone I. Methods: In a part retrospective (nine years) and part prospective (one year) interventional study, we analyzed eyes treated for ROP in posterior Zone I with a minimum follow-up for 6 months. Results: The study included 109 eyes of 56 infants; mean gestational age and birth weights were 29.3 (±2.1) weeks and 1112.5 (±381.9) grams, respectively. The treatment included intravitreal anti-Vascular Endothelial Growth Factor (anti-VEGF) as the initial treatment modality in 101 eyes (92.6%), either alone (27 eyes) or combined with laser or vitreous surgery (73 eyes). Laser was the initial treatment modality in 8 eyes, either alone-(n=3) or in combination with surgery (n=5). With anti-VEGF alone, 30.68% (n=27 eyes) responded favorably, and the remaining 69.32% (n=59) eyes needed re-treatment (laser in the majority). At the final follow-up, 89.9 % (out of 109) of eyes did well anatomically. Good outcome was significantly linked to no detachment at presentation (p<0.0001) and the presence of well-defined central vascular trunks (p=0.001). Conclusions: Treating the eyes before retinal detachment with bevacizumab followed by laser (and surgery, if needed) results in a favorable outcome in babies with posterior zone 1 ROP.

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Section: Discussionmentioning

confidence: 91%

“…Often, the vessels in very posterior ROP are thin, and the vascular–avascular junction can be difficult to appreciate. 27…”

Section: Discussionmentioning

confidence: 99%

Outcome of eyes treated for Retinopathy of Prematurity in Posterior Zone I: An Eastern India study.

Padhi,

Bhunia,

Shah

et al. 2024

Retina

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Characteristics of posterior zone I retinopathy of prematurity

Padhi

Shah

Sahoo

et al. 2023

Eye

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Retinopathy of Prematurity in Zone I posterior (Zone Half): Neonatal Profile, Clinical characteristics, and outcomes

Padhy

Shah²,

Sahu³

et al. 2022

Preprint

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Objective To report the demographic profile,clinical characteristics, and outcomes of retinopathy of prematurity (ROP) in Zone I posterior. Methods In a partly retrospective (ten years) and partly prospective (one year) study, we analyzed the demographic profile, clinical characteristics, treatment type, recurrences, and outcomes of babies with ROP in Zone I posterior. Results The study included 130 eyes of 67 infants with a mean gestational age and birth weight of 29.3 (± 2.2) weeks and 1217.3 (± 381.9) grams, respectively. All babies had received unblended oxygen with a poor weight gain in the majority.The ROP subtypes included aggressive,threshold, hybrid, stage 4, and atypical type in 78, 20, 11, 15, and 6 eyes, respectively. Fibrovascular proliferation when present,was prominent nasally, occasionally overriding the disc margin. Extensive arteriovenous tortuosity was more prominent than vascular dilatation. Atypical observations included bleb-like detachment(n = 6 eyes), candle wax-like preretinal deposits (n = 23 eyes), and large arteriovenous shunts (n = 9eyes). Primary treatment included intravitreal anti-VEGF in 119 eyes and laser in 11 eyes. Among those with follow-upfor more than 6 months, the recurrence was seen in 48.3% (n = 29) of eyes with anti-VEGF; with additional laser treatment, the outcome was favorable in 90.5% (n = 116) of eyes. Conclusions Zone I posterior ROP has a distinct profile with several atypical characteristics; it differsfrom ROP in other zones. Primary anti-VEGF treatment is beneficial but inadequate; most babies need additional laser or surgery.Improved neonatal care, earlier screening, and a combination of intravitreal anti-VEGF and laser are recommended.

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Atypical case of retinopathy of prematurity with candle wax-like preretinal deposits and its surprising response to intravitreal antivascular endothelial growth factor

Cited by 3 publications

References 7 publications

Outcome of eyes treated for Retinopathy of Prematurity in Posterior Zone I: An Eastern India study.

Outcome of eyes treated for Retinopathy of Prematurity in Posterior Zone I: An Eastern India study.

Characteristics of posterior zone I retinopathy of prematurity

Retinopathy of Prematurity in Zone I posterior (Zone Half): Neonatal Profile, Clinical characteristics, and outcomes

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