Time Course of Retinopathy of Prematurity Regression and Reactivation After Treatment with Ranibizumab or Laser in the RAINBOW Trial

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

“…Literature search 800 records were retrieved during the initial electronic database search, of which 30 studies were included in the meta-analysis (Figure 1). 6,10,12,24, The reasons for exclusion of studies were duplicated studies (261), outcome measures not relevant to this study (444), intervention or outcome not of interest (38), non-comparative studies (8), repeated cohort in follow-up studies (17), non-peer J o u r n a l P r e -p r o o f reviewed conference abstracts (1) and non-conventional follow up (1). The 30 included studies consisted of 4 RCTs and 26 retrospective consecutive cohorts (Table 1).…”

“…8 The RAINBOW trial showed that 0.2mg of intravitreal ranibizumab was as effective as, and possibly superior to, laser for Type 1 ROP. 9,10 Aflibercept (Eylea) is a 115 kDa fusion protein combining binding domains from human VEGF receptor 1, human VEGF receptor 2, and the Fc region of a human IgG1. Aflibercept binds to multiple isoforms of VEGF-A, VEGF-B and placental growth factor, thus 'trapping' these circulating VEGFs for degradation.…”

Primary and additional treatment preference in aggressive retinopathy of prematurity and type 1 retinopathy of prematurity

“…Reactivation phase proceeds in various ways from the demarcation line to the stage requiring treatment. However, reactivation is defined differently in the literature,37 and the degree of reactivation has been reported differently depending on the types and doses of therapeutic agents as well as the study period 38 39. In our study, treatment insufficiency and reactivation were classified based on 4 weeks before and after the first treatment.…”

Melatonin and its bioisosteres as potential therapeutic agents for the treatment of retinopathy of prematurity

“…However, treatment with these drugs is associated with complications: retinal avascularity, retinal detachment, or intravitreal angiogenesis (Chang et al., 2022; Yasin et al., 2023). Study of the efficacy of these drugs compared to laser therapy has been the subject of several large randomized trials, such as BEAT‐ROP (Mintz‐Hittner et al., 2011) (bevacizumab), CARE‐ROP (Stahl et al., 2018) (ranibizumab) and the most recent study—RAINBOW (Fleck et al., 2022) (also ranibizumab). The RAINBOW data demonstrated that incomplete disease regression was observed in 22% of cases with laser treatment and in 6%–8% of cases with ranibizumab treatment.…”

“…The RAINBOW data demonstrated that incomplete disease regression was observed in 22% of cases with laser treatment and in 6%–8% of cases with ranibizumab treatment. However, ROP reactivation occurred in only 2% of cases with laser treatment compared to 15%–17% of cases with ranibizumab treatment (Fleck et al., 2022). Currently, there are no drugs against ROP that minimize the risk of side effects or disease reactivation.…”