scholarly journals Intravitreal anti-VEGF therapy as an adjunct to laser photocoagulation for severe aggressive posterior retinopathy of prematurity

2013 ◽  
Vol 6 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Sengul Ozdek ◽  
Metin Unlu ◽  
Gokhan Gurelik ◽  
Berati Hasanreisoglu
Keyword(s):  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Anti Vegf

scholarly journals X-Linked Retinoschisis and a Coats-Like Response in the Setting of Retinopathy of Prematurity

2020 ◽  
Vol 4 (6) ◽  
pp. 525-529
Author(s):  
Kenneth C. Fan ◽  
Mark A. McAllister ◽  
Nicolas A. Yannuzzi ◽  
Nimesh A. Patel ◽  
Supalert Prakhunhungsit ◽  
...  
Keyword(s):  
Case Report ◽  
Young Patient ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Imaging Findings ◽  
Unique Combination ◽  
Unique Case ◽  
Anti Vegf ◽  
History Of

Purpose: This case report describes a unique case of a young patient with retinopathy of prematurity (ROP), a unilateral Coats-like response, and X-linked retinoschisis (XLRS). Methods: A 9-year-old boy with a history of regressed ROP presented with a unilateral Coats-like response, subretinal exudation, and XLRS. Examination and imaging findings demonstrated a highly unique combination of bilateral retinoschisis and a dramatic unilateral Coats-like response with a large schisis cavity. Results: Treatment with laser photocoagulation and anti-VEGF therapy led to resolution of the subretinal exudative changes. Conclusions: This is the first published description to our knowledge of a patient with a Coats-like response, XLRS, and a history of regressed ROP with resolution after treatment.

scholarly journals Foveal structure changes in infants treated with anti-VEGF therapy or laser therapy guided by optical coherence tomography angiography for retinopathy of prematurity

2022 ◽  
Vol 15 (1) ◽  
pp. 106-112
Author(s):  
Xun Deng ◽  
◽  
Xue-Mei Zhu ◽  
Dan-Dan Linghu ◽  
Hua Xu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Optical Coherence Tomography Angiography ◽  
Full Thickness ◽  
Anti Vegf ◽  
Laser Group ◽  
Type 1 Rop

AIM: To evaluate foveal vessel density (VD) and foveal thickness using optical coherence tomography angiography (OCTA) in retinopathy of prematurity (ROP) children treated with laser photocoagulation or anti-vascular endothelial growth factor (VEGF) injection. Additionally, we assessed the relationship between foveal microvascular anomalies and different therapies in ROP children. METHODS: This was a single-center, retrospective study of patients with a diagnosis of type 1 ROP. Twenty-three eyes (14 patients) treated with anti-VEGF injection and twenty-nine eyes (17 patients) treated with laser coagulation were included in this study. The foveal VD, inner thickness and full thickness were measured at the central 0°, 2° to 8°, and 8° of the retina (centered on the fovea) using OCTA and cross-sectional OCT, respectively. RESULTS: Foveal VD, inner thickness and full thickness were significantly smaller within the central 8° of the retina in ROP children treated with anti-VEGF injection than in those treated with laser photocoagulation (P=0.013, 0.009, 0.036, respectively). The full thickness was also smaller in the anti-VEGF group than in the laser group at the central 0° of the retina (P=0.010). The grade of foveal hypoplasia is lower in the anti-VEGF group than in the laser group (P=0.045). Multivariable analysis did not find any risk factors associated with visual acuity in our study. CONCLUSION: In children with type 1 ROP, the better structural development of fovea in those who were treated with anti-VEGF injection compared with laser photocoagulation are identified. However, visual acuity outcomes are similar 70mo after the treatments.

scholarly journals Anti-VEGF therapy of retinopathy of prematurity

2016 ◽  
Vol 11 (4) ◽  
pp. 212-220
Author(s):  
Nataliya Nikolaevna Sadovnikova ◽  
N. V Prisich ◽  
V. V Brzhesky
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Vitreous Body ◽  
Normal Lung ◽  
Peripheral Retina ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Endothelial Growth Factor

Laser photocoagulation of avascular retina remains the standard method for the treatment of retinopathy of prematurity (RP). At the same time, the outcomes of combined multi-stage surgical interventions on the patients presenting with this condition leave much to be desired. In the present review, we have undertaken the analysis of more than 50 articles related to the use of antibodies against the vascular endothelial growth factor (Anti-VEGF) that were published during the period from 2005 to 2015; the analysis included the use of the “off-label” medications as the potentially promising method for the treatment of retinopathy of prematurity. In the overwhelming majority of the studies, the use of anti-VEGF therapy as monotherapy or in the combination with conventional laser photocoagulation has been shown to be efficient for the treatment of stage III+ of the active period of retinopathy of prematurity. One of the important advantages of monotherapy is it does not cause the irreversible destruction of the peripheral retina, in contrast to the action of laser photocoagulation. Moreover, the intravitreal administration of the inhibitors of angiogenesis does not interfere with the growth of blood vessels in the peripheral retina as demonstrated by fluorescein angiography and electroretinography. At the same time, the results of certain published investigations give evidence of the important role played by the vascular endothelial growth factor in the processes of angiogenesis, glomerulogenesis, and alveolarization during the normal lung development. In addition, it has been demonstrated that bevacizumab can migrate from the vitreous body and penetrate into the systemic circulation where it causes the reduction of the serum VEGF levels in the infants presenting with retinopathy of prematurity. In connection with this, the majority of the authors emphasize the necessity of further investigations (based on the results of monitoring the concentration of serum VEGF) for the evaluation of the safety of such medications, their potential long-term effects on other organs and systems in the course of their development as well as possible adverse reactions they are likely to induce. Some problems related to the timing and dosage of the intravitreal administration of the inhibitors of angiogenesis remain a matter of controversy.

scholarly journals A Longitudinal Study of Retinopathy of Prematurity at Great Eastern Medical School and Hospital, Srikakulam

2021 ◽  
Vol 8 (11) ◽  
pp. 593-596
Author(s):  
Lakshmi Sativada ◽  
Dineshkanth Vudayana ◽  
Tejapraveen P ◽  
Jogendra Prasad Behra
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Medical School ◽  
Gestational Age ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Anti Vegf ◽  
Department Of Ophthalmology ◽  
Indirect Ophthalmoscope ◽  
Rop Screening

BACKGROUND Retinopathy of prematurity (ROP) is a vasculopathy affecting the premature retina. In India ROP is increasing due to the increased premature deliveries, well improved neonatal care and better neonatal survival rate. ROP screening by an experienced ophthalmologist plays an important role in screening, identifying and management of at-risk premature infants. Nowadays, the gold standard treatment is laser photocoagulation of avascular retina and anti-vascular endothelial growth factor (VEGF) depending on the severity of disease. METHODS This observational study included 152 babies who were referred to the Department of Ophthalmology at Great Eastern Medical School (GEMS), Srikakulam for ROP screening. The screening of eyes was done with a binocular indirect ophthalmoscope with 20 D lens. Eyes were examined by application of topical anaesthetic drops after applying topical tropicamide drops till full dilatation was noted. ROP was staged and treatment was given accordingly. RESULTS Totally 152 infants were screened for ROP in the Department of Ophthalmology. Babies with gestational age between 26 weeks and 36 weeks were included in the present study. Babies with birth weight between 900 gm and 2000 gm were also included in the study. Of the 152 babies which were included in the study, 54 babies presented with different stages of ROP. The incidence of ROP in the present study was found out to be 35.5 %. When incidence of ROP was noted with respect to birthweight, in extremely low birth weight (ELBW) babies, incidence was found out to be 71.4 %; in very low birth weight (VLBW) babies incidence rate was found to be 48.4 %. When incidence of ROP was noted with respect to gestational age ROP incidence was found to be 65.2 % in babies with gestational age of < 32 weeks. There was no association with gender in the incidence of ROP. When ROP incidence was noted in babies who received O2 therapy 59.2 % babies who received O2 therapy developed ROP. CONCLUSIONS In our study, at our institute the incidence of ROP was 35.5 %. With appropriate screening for the babies at risk we can prevent the development of ROP and further complications. According to study results our recommendations are that initial screening should to be done as early as 4 weeks of postnatal age or 34 - 35 weeks post conceptional age and to be followed till term gestation. In the present study we found that usage of anti VEGF came out with promising outcome results. The procedure of anti VEGF was relatively safe and easy with a smaller number of complications when compared to laser photocoagulation. KEYWORDS Retinopathy of Prematurity, Laser Photocoagulation, Indirect Ophthalmoscope, Tropicamide, Anti VEGF

scholarly journals Screening auf Frühgeborenenretinopathie – die wichtigsten Änderungen in der neuen deutschen Leitlinie 2020

2021 ◽  
Author(s):  
Jeany Q. Li ◽  
Ulrich Kellner ◽  
Birgit Lorenz ◽  
Andreas Stahl ◽  
Tim U. Krohne
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Retinopathy Of Prematurity ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Zone Ii ◽  
Endothelial Growth Factor ◽  
Rop Screening

Zusammenfassung Hintergrund Durch Verbesserungen in der neonatologischen Versorgung von Frühgeborenen und die Entwicklung neuer Behandlungsmöglichkeiten der Frühgeborenenretinopathie („retinopathy of prematurity“ [ROP]) haben sich die Anforderungen an das ROP-Screening seit der Veröffentlichung der letzten Fassung der deutschen Leitlinie zum ROP-Screening im Jahr 2008 verändert. Auf Grundlage aktueller Studiendaten wurde die Leitlinie in 2020 grundlegend überarbeitet und in einer aktualisierten Fassung veröffentlicht. Ziel Dieser Artikel fasst die wichtigsten Änderungen in der neuen Leitlinie zusammen. Ergebnisse Die Altersgrenze für einen Screeningeinschluss wurde für Kinder ohne zusätzliche Risikofaktoren auf ein Gestationsalter von unter 31 Wochen gesenkt. Die Mindestdauer für eine Sauerstoffsupplementation, die einen Einschluss in das Screening bei Frühgeborenen erforderlich macht, wurde auf über 5 Tage angehoben. Eine Behandlung bei ROP in Zone II kann nun schon bei jedem Stadium 3 mit Plus-Symptomatik unabhängig von der Anzahl der betroffenen Uhrzeiten erfolgen. Für die Nachkontrollen nach Anti-VEGF („vascular endothelial growth factor“)-Therapie wurden Kriterien zur Frequenz und Dauer definiert. Das verbindliche Dokument für diese und weitere neue Empfehlungen ist die Leitlinie selber. Schlussfolgerungen Die Empfehlungen der Leitlinie ermöglichen eine zuverlässige Identifikation von Kindern mit ROP-Risiko für den Einschluss in das Screening und eine rechtzeitige Erkennung fortgeschrittener Krankheitsstadien für die Therapieeinleitung, um so Erblindung durch ROP zu verhindern.

scholarly journals Combination of Intravitreal Ranibizumab and Laser Photocoagulation for Aggressive Posterior Retinopathy of Prematurity

2012 ◽  
Vol 3 (1) ◽  
pp. 136-141 ◽  
Author(s):  
Ágata Mota ◽  
Ângela Carneiro ◽  
Jorge Breda ◽  
Vitor Rosas ◽  
Augusto Magalhães ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Intravitreal Ranibizumab

Clinical Features and Outcomes of Infants with Retinopathy of Prematurity Who Fail Anti-VEGF Therapy

Retina ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lucy T. Xu ◽  
David A. Levine ◽  
Amy K. Hutchinson ◽  
Prethy Rao ◽  
G. Baker Hubbard
Keyword(s):  
Clinical Features ◽  
Retinopathy Of Prematurity ◽  
Anti Vegf

Efficacy of intravitreal conbercept injection in the treatment of retinopathy of prematurity

2018 ◽  
Vol 103 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Yichen Bai ◽  
Huanjie Nie ◽  
Shiyu Wei ◽  
Xiaohe Lu ◽  
Xiaoyun Ke ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Primary Outcome ◽  
Safety And Efficacy ◽  
Postmenstrual Age ◽  
Zone Ii ◽  
The Mean ◽  
Secondary Outcomes ◽  
Number Of Injections

BackgroundTo evaluate the safety and efficacy of intravitreal conbercept (IVC) injection in the treatment of retinopathy of prematurity (ROP).MethodsPatients with ROP who underwent IVC injection in Zhujiang Hospital from June 2015 to July 2016 were studied retrospectively. The primary outcome was defined as the regression of plus disease. The secondary outcomes were defined as the presence of recurrence, number of injections and the final regression of disease.ResultsA total of 48 eyes of 24 patients with ROP were included. Among them, 9 eyes of 5 patients had zone I ROP, 35 eyes of 18 patients had zone II ROP and 4 eyes of 2 patients had aggressive posterior ROP. The mean gestational age was 28.5±1.6 weeks, the mean birth weight was 1209.6±228.6 g, the mean postmenstrual age of first injection was 34.2±1.9 weeks and the mean follow-up period was 31.0±4.7 weeks. Forty of 48 eyes (83.3%) received IVC only once, and the regression of plus disease occurred at an average of 3.5±1.5 weeks after the first injection of conbercept. For eight recurrent eyes (16.7%), four eyes received a second IVC and the remaining four eyes received laser photocoagulation, and the regression of plus disease occurred in 3 weeks. No lens opacity, vitreous haemorrhage, entophthalmia or retinal detachment was observed during follow-up.ConclusionIVC injection is an effective treatment for ROP.

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