Intravitreal bevacizumab monotherapy for type-1 prethreshold, threshold, and aggressive posterior retinopathy of prematurity — 27 month follow-up results from Turkey

Yetik, Hüseyin; Günay, Murat; Sirop, Sarkis; Salihoğlu, Ziya

doi:10.1007/s00417-014-2867-0

Cited by 59 publications

(41 citation statements)

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“…These changes in retinal vasculature were also different from the pattern of APROP regression either naturally or following laser. We compared the observed vascular events with reports on similar changes of any kind after IVB 15,[25][26][27][28][29] (Table 3) at different doses reported so far in the literature. The saw-toothed shunts observed in all the seven eyes in our series had a striking resemblance to the recent description of 'tungsten filament sign' by Yetik et al 29 and needs special mention.…”

Section: Discussionmentioning

confidence: 92%

“…We compared the observed vascular events with reports on similar changes of any kind after IVB 15,[25][26][27][28][29] (Table 3) at different doses reported so far in the literature. The saw-toothed shunts observed in all the seven eyes in our series had a striking resemblance to the recent description of 'tungsten filament sign' by Yetik et al 29 and needs special mention. Although we agree with them that these could be pathognomonic sign of IVB injection in preterm babies, the fact that there were severe preretinal hemorrhage overlying it in one eye and progression to abnormal circumferential vessels in the other 3 eyes makes us to believe that they may not always be the marker of regression and should be followed up with care and caution.…”

Section: Discussionmentioning

confidence: 92%

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Serial evaluation of retinal vascular changes in infants treated with intravitreal bevacizumab for aggressive posterior retinopathy of prematurity in zone I

Padhi

Das

Rath

et al. 2015

Eye

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Purpose To evaluate the serial changes in retinal vasculature in infants treated with intravitreal bevacizumab (IVB) for aggressive posterior retinopathy of prematurity (APROP) in zone I. Methods Retrospective analysis of serial changes in retinal vasculature after IVB in the seven eyes of four babies with APROP in zone I. Results The initial regression, following IVB, was dramatic with reduction in vessel caliber and marked thinning and invisibility of the bridging shunts. Resurgent vascular development was very slow radially though there was continued abnormal vascular growth circumferentially. Common findings in all eyes were tangled vasculature and fine saw-toothed shunts. The variable findings were (1) new closely packed multilayered bridging shunts, long arching mature looking vessels, and finally a ridge at the periphery (n = 3 eyes) at 52 weeks of postmenstrual age (PMA); (2) status quo at the stage of saw-toothed shunt and ridge in both eyes for a long time (n = 2 eyes); and (3) multiple retinal hemorrhages within the vascularized retina and thick preretinal hemorrhage overlying the saw-toothed shunts and ridge that persisted for another 3 weeks and regressed 2 weeks after laser (n = 1). The eyes that received bevacizumab alone (3) did not show any abnormal vascularization at 56 weeks of PMA or beyond. Conclusions The retinal vascularization following IVB was different than normal in terms of its time, speed, and morphology; few of these changes are first to be reported in the literature (Medline search) and warrants further studies.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 92%

Serial evaluation of retinal vascular changes in infants treated with intravitreal bevacizumab for aggressive posterior retinopathy of prematurity in zone I

Padhi

Das

Rath

et al. 2015

Eye

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“…Intravitreal anti-VEGF therapy has been increasingly used in severe ROP cases; hence, whether or not the systemic leakage of anti-VEGF can cause any short-or longterm adverse effects on the tissues or organs has always been an issue (10)(11)(12)(13)(14). The effects of this therapy on other tissues, including the lungs, were not investigated thoroughly in the present study, although we have previously reported a better systemic clinical course of BPD in preterm babies after the injection of IVB (10).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, in recent years a new treatment modality involving the intravitreal injection of anti-VEGF (vascular endothelial growth factor) agents (intravitreal bevacizumab (IVB)) has been used in the treatment of ROP with high success rates of up to 100% in even the most aggressive forms of the disease (10)(11)(12)(13)(14). However, anti-VEGF agents can gain access to the systemic circulation following an intravitreal injection (15)(16)(17)(18)(19), and the systemic adverse effects of intravitreal anti-VEGF agents have always been a concern.…”

Section: Introductionmentioning

confidence: 99%

Effects of Intravitreal Anti-VEGF Therapy on the Clinical Course of Bronchopulmonary Dysplasia

et al. 2016

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Objectives: To demonstrate the effects of the injection of intravitreal bevacizumab (IVB) on the clinical course of established bronchopulmonary dysplasia (BPD). Methods: This is a multicenter retrospective case-control study performed without any randomization or masking procedure. A total of 70 patients with BPD, including 35 cases (the IVB group) and 35 controls (the control group) were studied. Patients in the IVB group received intravitreal anti-VEGF (bevacizumab) treatment for type 1 prethreshold retinopathy of prematurity (ROP). The control group consisted of infants with BPD whose gestational age, birthweight, and gender were matched with those of the IVB group. None of the infants in the control group needed to be treated for ROP using either anti-VEGF or laser photocoagulation. Results: There was no statistically significant difference (P = 0.11) between the groups in terms of the total duration of oxygen prior to the IVB injection (65.9 ± 23.5 and 79.1 ± 33.1 days in the IVB group and control group, respectively). However, after the injection of IVB, the total duration of oxygen was significantly lower in the IVB group (mean 7 (1 -70) days vs. 16 (1 -98) days, P = 0.01). In 14 cases with mild BPD and their matched controls, the median time (25% -75%) for the discontinuation of oxygen therapy was 3 (2 -7) days and 10 (5 -15) days, respectively (P = 0.36). In 21 cases with moderate and severe BPD and their matched controls, the median time (25 -75%) for the discontinuation of oxygen therapy was 14 (7 -21) days and 22 (16 -43) days, respectively (P = 0.024). Conclusions: Intravitreal bevacizumab injection treatment for ROP cases with BPD was found to be associated with a shorter duration of oxygen use. The results of the study not only demonstrate a pathogenic correlation between ROP and BPD through an abnormal vasculogenesis, but also raise a question regarding whether or not the systemic side effects of IVB are actually adverse.

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“…63,64,65,66 PROGNÓSTICO APÓS O TRATAMENTO DA ROP A ROP habitualmente regride na maioria dos pacientes que desenvolvem apenas os estadiamentos 1 ou 2, pois a vascularização da retina periférica pode ir se completando nas semanas seguintes ao nascimento prematuro, deixando poucas alterações anatômicas e funcionais residuais que não necessitam de nenhum tratamento específico. Esses pacientes precisam apenas de acompanhamento evolutivo, durante os primeiros anos de sua vida, para a prevenção de ambliopia e do estrabismo e para a correção de ametropias, cujas incidências parecem ser maiores em RNP, quando comparadas com nascidos não prematuros.…”

Section: 5152unclassified

Retinopatia da prematuridade

Tartarella¹,

Filho²

2016

e-oftalmo

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RESUMOEste artigo aborda aspectos atuais sobre a retinopatia da prematuridade (ROP), entidade clínica responsável pela maior quantidade de crianças cegas em todo o mundo nos dias de hoje. Procura chamar a atenção para a importância da triagem na busca da doença em todos os prematuros de muito baixo peso e a necessidade de que a retinopatia seja identificada no momento adequado e tratada pelo laser ao redor da 37ª semana de idade pós-concepção, quando ainda existe chance para o tratamento que deverá ser feito, preferencialmente, durante o tempo de permanência da criança no Centro de Neonatologia. O exame oftalmológico inicial deve ser realizado sob oftalmoscopia binocular indireta e dilatação das pupilas, entre a 4ª e a 6ª semana de vida, em todos os recém-nascidos com peso igual ou menor do que 1500 gramas e/ou com idade gestacional igual ou inferior a 32 semanas conforme proposto pelas Diretrizes Brasileiras de Triagem e Detecção da ROP. O acompanhamento das crianças com ou sem retinopatia deverá seguir periodicamente até a normalização da vascularização da retina temporal na zona III e deverá ser mantido pelos primeiros anos de vida para a prevenção da ambliopia e do estrabismo e para a correção das altas ametropias relacionadas com a prematuridade. ABSTRACTThis study discusses current aspects regarding retinopathy of prematurity (ROP), a clinical disorder that leads to the highest number of children in the world becoming blind. This emphasizes the importance of screening for the disease in all preterm infants with a very low birth weight, identifying retinopathy at a proper time, and treating it using laser at about 37 weeks post-conception while there is still a chance for treatment, which should preferably be conducted during the child stay at the Neonatology Center. The first ophthalmic examination should be performed using binocular indirect ophthalmoscopy, with dilated pupils, between 4 and 6 weeks after birth in all newborns weighing 1,500 g or less and/or at the gestational age of 32 weeks or less, as proposed by the Brazilian Guidelines for ROP Screening and Detection. The follow-up of children with or without retinopathy should be conducted periodically until vascularization of Zone 3 temporal retina is normalized, and this normalization should be maintained during the first years of life for the prevention of amblyopia and strabismus and for the correction of refractive errors related to prematurity. RESUMENEste artículo aborda aspectos actuales sobre a retinopatía de la precocidad (ROP), entidad clínica responsable por la mayor cantidad de niños ciegos en todo el mundo en la actualidad. Busca llamar la atención a la importancia de un sistema de clasificación (triaje) en la búsqueda de la enfermedad en todos los prematuros de muy bajo peso y la necesidad de que la retinopatía se identifique en el momento adecuado y se trate por medio de láser alrededor de la 37ª semana de edad post-concepción, cuando aún hay oportunidad para el tratamiento que deberá hacerse, preferencialmente, durante el tiempo de ...

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Intravitreal bevacizumab monotherapy for type-1 prethreshold, threshold, and aggressive posterior retinopathy of prematurity — 27 month follow-up results from Turkey

Abstract: IVB injection as monotherapy seems to be a very effective treatment modality for ROP. Based on timely intervention, IVB as a single treatment modality can salvage almost all ROP cases before stage 4.

Cited by 59 publications

References 29 publications

Serial evaluation of retinal vascular changes in infants treated with intravitreal bevacizumab for aggressive posterior retinopathy of prematurity in zone I

Serial evaluation of retinal vascular changes in infants treated with intravitreal bevacizumab for aggressive posterior retinopathy of prematurity in zone I

Effects of Intravitreal Anti-VEGF Therapy on the Clinical Course of Bronchopulmonary Dysplasia

Retinopatia da prematuridade

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