Follow-up to Age 4 Years of Treatment of Type 1 Retinopathy of Prematurity Intravitreal Bevacizumab Injection versus Laser: Fluorescein Angiographic Findings

Lepore, Domenico; Quinn, Graham E.; Molle, Fernando; Orazi, Lorenzo; Baldascino, Antonio; Ji, Marco H.; Sammartino, Maria Pia; Sbaraglia, Fabio; Ricci, Daniela; Mercuri, Eugenio

doi:10.1016/j.ophtha.2017.08.005

Cited by 109 publications

(70 citation statements)

References 36 publications

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“… 6 , 22 One study of 20 bevacizumab-treated ROP eyes showed peripheral and posterior pole abnormalities including vessel leakage, shunts, and tangles in patients 4 years of age. 23 Also, when evaluating fluorescein angiograms between 44 and 150 weeks of age of 30 ranibizumab-treated eyes, vascularization to zone III occurred in only 50% of eyes, and most of the 30 eyes had evidence of vascular abnormalities. 24 Indeed, surveyed ophthalmologists note that longer follow-up is the cause for preferring laser treatment in order to ensure adequate ROP regression, especially in patients who may not be followed up adequately.…”

Section: Discussionmentioning

confidence: 99%

Retinopathy of prematurity: preferred practice patterns among pediatric ophthalmologists

Jain

Song

Al-Holou

et al. 2018

OPTH

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PurposeThe treatment of retinopathy of prematurity (ROP) is not standardized and can vary significantly between providers. This study aims to determine preferred practices in treating ROP by globally surveying pediatric ophthalmologists.MethodsBetween January and February 2017, an international pediatric ophthalmology interest group was invited to complete an anonymous survey of 18 questions. The main objectives were to determine the preferred first line of treatment for ROP, the preferred dosage of intravitreal bevacizumab (IVB) used, and the outcome and possible complications following bevacizumab injection.ResultsOut of 101 pediatric ophthalmologists, 72 (71.8%) stated that they had direct involvement in the treatment of ROP. When presented with type 1 ROP which requires treatment, 69 ophthalmologists (68.3%) stated that they prefer laser treatment over bevacizumab, and 33 ophthalmologists (32.7%) stated they would recommend bevacizumab as a first choice. Ninety-three ophthalmologists (92.1%) reported the success of 1 laser treatment between 75% and 100%, and 35 ophthalmologists (34.7%) perceive bevacizumab to be 75%–100% successful. Half dose of adult-prescribed bevacizumab at 0.625 mg/0.05 mL was preferred by 47 of the ophthalmologists (46.5%). No cases of endophthalmitis were reported with intravitreal injection.ConclusionLaser photoablation remains the preferred mode of treatment for ROP among surveyed ophthalmologists across the world. Though bevacizumab is currently being used, this form of treatment is not as common, primarily due to the unknown safety profile and potential long-term ramifications of the drug.

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Section: Discussionmentioning

confidence: 99%

Retinopathy of prematurity: preferred practice patterns among pediatric ophthalmologists

Jain

Song

Al-Holou

et al. 2018

OPTH

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“…However, with the advent of agents that inhibit the bioactivity of vascular endothelial growth factor (VEGF) and studies that test efficacy and safety of dose, it has been realized that anti-VEGF agents can change the natural history of ROP and that intravitreal neovascularization and later tractional retinal detachments occur even a year after an injection [ 25 ]. Fluorescein angiography has increasingly been used to understand the pathophysiologic course of ROP following intravitreal anti-VEGF agents [ 26 – 28 ]. In the only report of the use of UWFA in infants with retinopathy of prematurity (ROP), Fung and colleagues published a consecutive case series of 3 infants with ROP born 24–29 weeks gestation that underwent UWFA in an outpatient office setting [ 29 ].…”

Section: Retinopathy Of Prematuritymentioning

confidence: 99%

The utility of ultra-widefield fluorescein angiography in pediatric retinal diseases

Calvo

Hartnett

2018

Int J Retin Vitr

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BackgroundUltra-widefield angiography is the latest technology in the evolution of fundus fluorescein angiography. With the ability to capture up to 200° of the fundus in a single image, far peripheral retinal pathology can be imaged. Generally, obtaining high-quality fundus fluorescein angiography in a child without sedation in the outpatient setting is exceedingly challenging. Therefore, there are advantages to imaging platforms that can capture the peripheral retina in young children without anesthesia. Often pediatric retinal diseases have pathology localized to the far periphery, which further validates the utility of ultra-widefield angiography. Ultra-widefield angiography has been successfully used without sedation for evaluation of children with various pediatric retinal diseases such as Coats disease, familial exudative vitreoretinopathy, and retinopathy of prematurity.ConclusionThis non-contact, non-mydriatic modality has been utilized in the evaluation of pediatric retinal diseases and demonstrated to have benefits over conventional fluorescein angiography techniques.

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“…Mittels Angiografie können periphere ischämische Netzhautareale sichtbar und in gewissen Grenzen auch quantifiziert werden [3] [6,7]. Dennoch verbleiben häufig periphere Netzhautanteile scheinbar avaskulär, ein Befund, den man toleriert, aber aus bislang ungeklärter klinischer Relevanz und vor dem Hintergrund möglicher Spätrezidive mit Netzhautablösung in regelmäßigen Abständen kontrolliert [8,9]. Im Gegensatz dazu konnte mit einer Lasertherapie der ischämischen avaskulären Peripherie bei zentralen ROP-Stadien nur eine sehr kleine Netzhautrestinsel erhalten werden, die Gefäße wuchsen nicht über die pathologische Leiste in die Peripherie hinaus.…”

Section: Allgemeine Und Technische üBerlegungenunclassified

Ultraweitwinkel-Fundusfotografie und -angiografie in der Differenzialdiagnose und zur Therapieplanung bei peripheren vaskulären Netzhauterkrankungen

Joussen

Brockmann

Urban

et al. 2018

Klin Monatsbl Augenheilkd

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Investigation of vascular diseases of the peripheral retina requires imaging procedures that allow a comprehensive view of the periphery, as well as reproducible pictures. In particular, ultra-wide field fluorescence angiography facilitates diagnosis, therapeutic decisions and follow-up examinations. While vasculopathies such as Coats disease and familiar exudative vitreoretinopathy are diagnosed within the first and second decade of life, patients' compliance during fundus imaging is typically reduced within this age range. Compared to the repeated imaging procedures for composite formation, ultra-wide field imaging has significantly reduced recording time. Nevertheless, current imaging systems are not able to map the entire retina in scaled proportions. Therefore, the imaging frame must be guided by patients' gaze onto the affected retinal area. Moreover, the medical photographer must be aware of the clinical setting and the region of interest. Hence, previous detailed funduscopy by trained ophthalmologists will remain indispensable.

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Follow-up to Age 4 Years of Treatment of Type 1 Retinopathy of Prematurity Intravitreal Bevacizumab Injection versus Laser: Fluorescein Angiographic Findings

Cited by 109 publications

References 36 publications

Retinopathy of prematurity: preferred practice patterns among pediatric ophthalmologists

Retinopathy of prematurity: preferred practice patterns among pediatric ophthalmologists

The utility of ultra-widefield fluorescein angiography in pediatric retinal diseases

Ultraweitwinkel-Fundusfotografie und -angiografie in der Differenzialdiagnose und zur Therapieplanung bei peripheren vaskulären Netzhauterkrankungen

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