Refractive and Biometric Outcomes in Patients with Retinopathy of Prematurity Treated with Intravitreal Injection of Ranibizumab as Compared with Bevacizumab: A Clinical Study of Correction at Three Years of Age

Abstract

Purpose To compare refractive and biometric outcomes in patients with type 1 retinopathy of prematurity (ROP) treated with intravitreal injection of ranibizumab (IVR) versus bevacizumab (IVB), at a corrected age of 3 years. Methods A retrospective case series compared cycloplegic refractive statuses and biometric statuses in patients who received either IVR or IVB for type 1 ROP, from April 2011 to April 2014. Results A total of 62 eyes (33 patients) with type 1 ROP were evaluated (26 eyes in 13 IVR patients and 36 eyes in 20 IVB patients). There were no differences in birth statuses including gestational age and birth body weight between the two groups. The prevalence of refractive error greater than 1 D was higher in the IVB group (p = 0.03), and there was a higher prevalence of high myopia (<−5.0 D, p = 0.03) in the IVB group. Comparisons in biometric finding showed that IVB patients had shallower anterior chamber depth (p = 0.01). Conclusion Both IVR and IVB showed low refractive errors, even followed at the corrected age of 3 years. No difference was noted between the two groups in refractive statuses. However, IVB was associated with shallower anterior chamber and higher prevalence of refractive error at the corrected age of 3 years. This trial is registered with NCT03334513.

Longitudinal Development of Refractive Error in Children Treated With Intravitreal Bevacizumab or Laser for Retinopathy of Prematurity

“…Although these differences in prevalence did not reach statistical significance, their trend is in agreement with the observations of Gunay et al, 18 who noted a significantly higher prevalence of anisometropia in children with ROP treated with laser (66.7%) compared with those treated with IVB (20%, P = 0.009). Our results for the IVB cohort are also in agreement with the overall prevalence in IVB-treated infants reported by Chen et al 19 of 35%. 13 Anisometropia may occur more frequently in laser-treated infants because asymmetric disease may necessitate the need for a greater treatment area in one eye compared to the other.…”

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

“…The 30 included studies consisted of 4 RCTs and 26 retrospective consecutive cohorts (Table 1). 11 studies comparing bevacizumab with laser therapy, 6,24,[35][36][37][38][39][40][41][42][43] 6 studies comparing ranibizumab with laser, 10,44-48 5 studies comparing bevacizumab with ranibizumab, [53][54][55][56][57] 3 studies comparing bevacizumab, ranibizumab and laser, [50][51][52] 2 studies comparing aflibercept with laser, 12,49 1 study comparing ranibizumab and aflibercept, 58 1 study compared bevacizumab and aflibercept and 1 study compared bevacizumab, ranibizumab, aflibercept. 60 In total, these comprise 4686 eyes of 2408 infants that received primary treatment for ROP with bevacizumab (2081 eyes), ranibizumab (727 eyes), aflibercept (326 eyes), or laser (1552 eyes).…”

Refractive outcomes in infants treated for retinopathy of prematurity

“…Based on the reported refractive outcomes, we divided the studies into four categories: 1) those that revealed a lower rate of refractive error in the anti-VEGF treated eyes [20][21][22]; 2) those that revealed no significant difference in refractive outcomes between the two treatment modalities [9,16,23]; 3) those that revealed a higher rate of refractive error in the anti-VEGF treated eyes [24] or compared refractive outcomes between two anti-VEGF agents [25][26][27]; and 4) those that reported refractive outcome of sequential treatment with laser after initial anti-VEGF treatment [28,29]. Table 1 summarizes the refractive outcomes reported in the 33 primary studies.…”