Intravitreal bevacizumab as rescue therapy following treatment failure with laser photocoagulation in retinopathy of prematurity

Kara, Caner; Hekimoğlu, Emre; Petriçli, İkbal Seza; Akıl, Handan

doi:10.1016/j.joco.2017.08.007

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…Anti-VEGF agents are frequently used together with laser photocoagulation in the treatment of APROP (26). In some studies, anti-VEGF injection is recommended as rescue therapy in cases of laser photocoagulation failure (27). However, in a small number of series, it was shown that laser photocoagulation can be used if the disease progresses after IVI (28).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Infants with Retinopathy of Prematurity Treated with Intravitreal Bevacizumab

Özdemir¹,

Ceran²,

Akin³

et al. 2022

Turkish Journal of Pediatric Disease

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Objective: To evaluate the systemic and local effects and side effects of intravitreal bevacizumab injection in preterm infants with aggressive posterior retinopathy of prematurity.Material and Methods: A total of 16 patients were included in this single-center observational cohort study between June 2020 and March 2021. The clinical, laboratory, and radiological findings before and after intravitreal injection of 0.3 mg bevacizumab were recorded for a total of 32 eyes. Results:The patients' mean gestational age at birth was 25±0.38 weeks and their mean birth weight was 695±119.2 g. None of the patients developed complications such as local vitreous hemorrhage or endophthalmitis secondary to intravitreal injection administered at a postmenstrual age of 34 weeks, and none required repeated injections. There was no increase in the rate of intraventricular hemorrhage after injection. There was no statistically significant difference in the patients' laboratory parameters, blood pressure values, or systemic findings before and after treatment. Conclusion:Although no systemic or local side effects were observed in patients treated with intravitreal bevacizumab injection in this study, patients should be monitored closely for systemic hypertension, intraventricular hemorrhage, and hypotension. More detailed studies are needed to evaluate later neurodevelopmental outcomes compared to other treatment options.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Infants with Retinopathy of Prematurity Treated with Intravitreal Bevacizumab

Özdemir¹,

Ceran²,

Akin³

et al. 2022

Turkish Journal of Pediatric Disease

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“…15 Further, laser therapy may be required in the case of contraindications to anti-VEGF, such as conjunctivitis or external eye infections. 90 Contraindications to using intravitreal anti-VEGF include ocular or periocular infections and severe intraocular inflammation. 47 Figure 1 represents a case study where bevacizumab is followed by laser therapy.…”

Section: Few Clinical Scenarios For Rop Managementmentioning

confidence: 99%

Role of Anti-Vascular Endothelial Growth Factor (Anti-VEGF) in the Treatment of Retinopathy of Prematurity: A Narrative Review in the Context of Middle-Income Countries

Dogra¹,

Vinekar²

2023

PHMT

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The rise in preterm births and higher survival rates of premature infants have led to a global increase in retinopathy of prematurity (ROP), a vasoproliferative retinal disorder common in premature infants. ROP is one of the leading causes of childhood blindness. Clinical manifestation of ROP ranges from mild abnormal retinal neovascularization to bilateral retinal detachment and vision loss. The incidence of ROP is higher in middle income countries, including India, which has the highest number of global preterm births. Low birth weight and low gestational age are the primary risk factors for ROP; however, anemia, cardiac defects, blood transfusion, apnea, sepsis, respiratory distress syndrome, high exposure to oxygen and poor postnatal weight gain may also contribute to its development. India has stringent ROP screening guidelines revised in 2018, and screening of infants with either birth weight <2000 grams or gestational age <34 weeks is mandated. With an improved understanding of the pathogenesis of ROP in the past decades and advances in clinical research, treatment for ROP has evolved from cryotherapy to laser retinal ablation. Most recently, anti-vascular endothelial growth factor (anti-VEGF) drugs have emerged as a favorable treatment option for zone-I and II ROP. This article reviews the current approaches for ROP treatment in India with a particular focus on anti-VEGF drugs. The article also integrates the understanding of safety and risk-benefit evaluation of the current approaches in ROP management. The review concluded that there is a need to increase the ROP screening not only for preterm and low birth weight but also for optimal gestational age infants with healthy birth weight. Anti-VEGF therapies have shown improved efficacy, although studies are required to establish the long-term safety.

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“…This understanding forms the basis for our current therapeutic interventions, which are aimed at amelioration of neovascularization in the second phase of ROP. These include ablation of avascular retinal tissues, now done with laser, or reduction in expression of the proangiogenic growth factor VEGF and can be administered as a monotherapy or as sequential therapy [29][30][31].…”

Section: Rop Molecular Pathogenesis Informs Current Rop Interventionsmentioning

confidence: 99%

Current evidence and outcomes for retinopathy of prematurity prevention: insight into novel maternal and placental contributions

Carroll

Owen

2020

Exploration of Medicine

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Retinopathy of prematurity (ROP) is a blinding morbidity of preterm infants, which represents a significant clinical problem, accounting for up to 40% of all childhood blindness. ROP displays a range of severity, though even mild disease may result in life-long visual impairment. This is complicated by the fact that our current treatments have significant ocular and potentially systemic effects. Therefore, disease prevention is desperately needed to mitigate the life-long deleterious effects of ROP for preterm infants. Although ROP demonstrates a delayed onset of retinal disease following preterm birth, representing a potential window for prevention, we have been unable to sufficiently alter the natural disease course and meaningfully prevent ROP. Prevention therapeutics requires knowledge of early ROP molecular changes and risk, occurring prior to clinical retinal disease. While we still have an incomplete understanding of these disease mechanisms, emerging data integrating contributions of maternal/placental pathobiology with ROP are poised to inform novel approaches to prevention. Herein, we review the molecular basis for current prevention strategies and the clinical outcomes of these interventions. We also discuss how insights into early ROP pathophysiology may be gained by a better understanding of maternal and placental factors playing a role in preterm birth.

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Intravitreal bevacizumab as rescue therapy following treatment failure with laser photocoagulation in retinopathy of prematurity

Cited by 6 publications

References 26 publications

Evaluation of Infants with Retinopathy of Prematurity Treated with Intravitreal Bevacizumab

Evaluation of Infants with Retinopathy of Prematurity Treated with Intravitreal Bevacizumab

Role of Anti-Vascular Endothelial Growth Factor (Anti-VEGF) in the Treatment of Retinopathy of Prematurity: A Narrative Review in the Context of Middle-Income Countries

Current evidence and outcomes for retinopathy of prematurity prevention: insight into novel maternal and placental contributions

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