Systemic conbercept pharmacokinetics and VEGF pharmacodynamics following intravitreal injections of conbercept in patients with retinopathy of prematurity

2021 ◽  
pp. bjophthalmol-2021-319131
Author(s):  
Yong Cheng ◽  
Shuang Sun ◽  
Xun Deng ◽  
Xuemei Zhu ◽  
Dandan Linghu ◽  
...  
Keyword(s):  
Retinopathy Of Prematurity ◽  
Intravitreal Injections ◽  
Vascular Endothelial ◽  
Randomised Study ◽  
Limit Of Quantitation ◽  
Significant Difference ◽  
Endothelial Growth Factor ◽  
Type 1 Rop

BackgroundData on serum vascular endothelial growth factor (VEGF) and drug levels in patients with retinopathy of prematurity (ROP) following intravitreal injections of conbercept (IVC) are lacking.MethodsMulticentre, prospective, non-randomised study of patients with aggressive posterior retinopathy of prematurity (APROP) or type 1 ROP who had not received other treatment. All infants received therapy in both eyes plus intravitreal IVC 0.25 mg/0.025 mL in one eye and had at least 6 months of follow-up. Blood samples were collected before and 1 week and 4 weeks after IVC. The main outcome measures were serum conbercept and VEGF concentrations.ResultsForty infants with APROP or type 1 ROP were enrolled. The mean serum VEGF at baseline and 1 week and 4 weeks after a total of 0.25 mg of IVC was 953.35±311.90 pg/mL, 303.46±181.89 pg/mL and 883.12±303.89 pg/mL, respectively. Serum VEGF 1 week after IVC was significantly lower (p<0.05) than baseline, and at 4 weeks after IVC, it was significantly higher (p<0.05) than at 1 week. There was no significant difference (p>0.05) between baseline and 4 weeks. Serum conbercept was below the limit of quantitation (BLOQ) at baseline and 4 weeks and was 19.81±7.60 ng/mL at 1 week.ConclusionSerum VEGF 1 week after IVC was significantly lower than baseline but returned to baseline at 4 weeks. Serum conbercept increased at 1 week and was BLOQ at 4 weeks.

scholarly journals Angiographic Findings in Cases with a History of Severe Retinopathy of Prematurity Treated with anti-VEGFs Follow-up to Age 6 Years

2021 ◽  
Author(s):  
Hande Celiker ◽  
Ozlem Sahin
Keyword(s):  
Laser Treatment ◽  
Retinopathy Of Prematurity ◽  
Posterior Pole ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
History Of ◽  
Endothelial Growth Factor ◽  
Developmental Features

Abstract Purpose: To report the effects of anti-vascular endothelial growth factor (VEGF) treatment in vascular development for cases of acute retinopathy of prematurity (ROP) using fluorescent angiography (FA) and to present the results of our observational approach to retinal sequelae.Methods: A total of 31 eyes in 19 patients with a history of treatment with anti-VEGF agents for classic type 1 ROP and aggressive posterior ROP who underwent FA between March 2014 to February 2020 were reviewed. Angiograms of retinal developmental features of patients aged 4 months to 6 years were examined. Results: The patients mean gestational age were 26.06±1.90 weeks and the mean birth weight were 837.68±236.79g. All cases showed various abnormalities at the vascular and avascular retina, and the posterior pole. All but one case showed a peripheral avascular area on FA evaluation during the follow-up period. We did not apply prophylactic laser treatment to these avascular retina. On the final examination, except one case, we did not observe any late reactivation in any patients. Conclusion: FA is an important tool for assessing vascular maturation in infants. Every leakage should not be assumed to be evidence of late activation, as some leaks may be related to vascular immaturity. Retinal vascularization may not be completed in all patients, however this does not mean that all these patients need prophylactic laser application. Our observational approach may be more daring than the reports frequently encountered in the literature, but it should be noted that unnecessary laser treatment will also eliminate all the advantages of anti-VEGF treatment.

scholarly journals Anti-Vascular Endothelial Growth Factor Therapy for Primary Treatment of Type 1 Retinopathy of Prematurity

Ophthalmology ◽  
2017 ◽  
Vol 124 (5) ◽  
pp. 619-633 ◽  
Author(s):  
Deborah K. VanderVeen ◽  
Michele Melia ◽  
Michael B. Yang ◽  
Amy K. Hutchinson ◽  
Lorri B. Wilson ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Retinopathy Of Prematurity ◽  
Primary Treatment ◽  
Vascular Endothelial ◽  
Factor Therapy ◽  
Growth Factor Therapy ◽  
Endothelial Growth Factor

scholarly journals Asymmetric Outcomes of Type 1 Retinopathy of Prematurity after Bilateral Intravitreal Ranibizumab Treatment

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Qiujing Huang ◽  
Qi Zhang ◽  
Yu Xu ◽  
Xunda Ji ◽  
Ping Fei ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Retinopathy Of Prematurity ◽  
Vitreous Hemorrhage ◽  
High Rate ◽  
Intravitreal Ranibizumab ◽  
Outcome Group ◽  
Significant Difference ◽  
Type 1 Rop ◽  
Ranibizumab Treatment

Purpose. To present cases with retinopathy of prematurity (ROP), who were treated with intravitreal injection of ranibizumab (IVR) and had unpredictable asymmetric outcomes. Methods. A retrospective review was performed in infants with type 1 ROP and had bilateral IVR (0.25 mg/0.025 mL) as initial treatment. Patients were classified into the asymmetric outcome group and the symmetric outcome group. Results. Eighty-four patients (168 eyes) were included. There were 18 eyes of 9 patients (10.7%) in the asymmetric outcome group and 150 eyes of 75 patients (89.3%) in the symmetric outcome group. In the symmetric outcome group, 86 eyes (57.3%) had ROP regression, 60 eyes (40%) had reactivation requiring laser treatment, and 4 eyes (2.7%) progressed to retinal detachment requiring vitrectomy. In the asymmetric outcome group, one of the eyes of the 9 patients had ROP regression with/without reactivation after IVR, while the contralateral eyes had negative response, including remarkable posterior fibrosis, partial or total retinal detachment, and vitreous hemorrhage. There was statistically significant difference between the birth weight of the two groups. Conclusion. Contralateral eyes with ROP can take a different clinical course after ranibizumab treatment. High rate of reactivation after IVR is another concern that ophthalmologists should pay attention to.

Association of -634 C/G Polymorphism at Vascular Endothelial Growth Factor Gene with Risk Retinopathy of Prematurity

2020 ◽  
Author(s):  
Mohammadamin Ghadyani ◽  
Mahmood Noorishadkam ◽  
Seyed Hamed Hosseini-Jangjou ◽  
Reza Bahrami ◽  
Elahe Akbarian ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Retinopathy Of Prematurity ◽  
Newborn Infants ◽  
Large Sample Size ◽  
Vascular Endothelial ◽  
Background Retinopathy ◽  
Study Results ◽  
Significant Difference ◽  
Endothelial Growth Factor

Background: Retinopathy of prematurity (ROP) is a major cause of blindness in newborn infants worldwide. It is well known that neovascularization of the retina is prominent in the proliferative stages of ROP. It is suggested that vascular endothelial growth factor (VEGF) may play a role in the development of ROP. The aim of this study was to evaluate the association of the VEGF -634C/G polymorphism at VEGF with risk of ROP. Methods: In the study 54 neonates diagnosed with ROP and 55 healthy neonates served as controls. The VEGF -634 C/G polymorphism was genotyped by restriction fragment length polymorphism (PCR-RFLP) technique. Results: The CC, CG, and GG genotypes of VEGF -634C/G polymorphism were found in 33.3%, 38.9%, and 27.8% of neonates with ROP, respectively. In controls, CC, CG, and GG genotypes were seen in 43.6%, 45.4%, and 10.9%, respectively. Frequency of mutant allele (C) was 52.8% in neonates with ROP and 66.4% in healthy neonates. There was a significant difference in the distribution of VEGF -634C/G polymorphisms between cases and controls. Moreover, there was a significant association between VEGF -634C/G polymorphisms and ROP risk (OR = 3.141, 95% CI 1.115-8.851, P = 0.030). Conclusion: This study results revealed that VEGF -634C/G polymorphism might serve as a risk factor for development of ROP. Thus, clinicians should be aware of the ROP risk in infant with the VEGF -634C/G polymorphism and ROP risk in infants. However, large sample size and well-designed studies are necessary to validate our findings.

scholarly journals Enlargement rate of geographic atrophy before and after secondary CNV conversion with associated anti-VEGF treatment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jakob Siedlecki ◽  
Caroline Koch ◽  
Benedikt Schworm ◽  
Raffael Liegl ◽  
Thomas Kreutzer ◽  
...  
Keyword(s):  
Growth Rate ◽  
Geographic Atrophy ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Significant Difference ◽  
Before And After ◽  
Endothelial Growth Factor ◽  
Mean Time ◽  
Larger Sample

Abstract Background To study the enlargement rate of primary geographic atrophy (GA) before and after diagnosis of a secondary choroidal neovascularization (CNV) treated with anti-vascular endothelial growth factor (VEGF) therapy. Methods Five hundred twenty-two consecutive eyes with primary GA were screened for the development of a complicating secondary CNV. Geographic atrophy was measured on blue autofluorescence (BAF) by two readers and calculated into mean growth rate before and after CNV diagnosis. Results Ten eyes of six patients were included in the study (six study eyes with GA complicated by CNV, four GA only partner eyes). Follow-up was 1.42 ± 0.48 years before and 3.64 ± 2.73 years after CNV. There was no significant difference between mean growth rate before and after CNV (1.58 ± 0.99 vs. 1.39 ± 0.65 mm2/year; p = 0.44) or between study and partner eyes (p = 0.86). Over a mean time of 3.64 ± 2.73 years, a mean of 8.3 ± 2.8 anti-VEGF injections were given. No correlation between the amount of anti-VEGF injections and change in growth rate could be observed (r = 0.58; p = 0.23). Conclusion In this pilot study, primary GA enlargement did not seem to be influenced by a secondary CNV. No association between the intensity of anti-VEGF treatment and changes in atrophy enlargement rates were found. Further studies with larger sample sizes are warranted.

INTRAVITREAL RANIBIZUMAB INJECTION AS TREATMENT IN PATIENTS WITH TYPE 1 RETINOPATHY OF PREMATURITY

2021 ◽  
pp. 13-15
Author(s):  
Kalishankar Das ◽  
Athokpam Poireiton ◽  
Sneha Bhowmick
Keyword(s):  
Cohort Study ◽  
Intravitreal Injection ◽  
Retinopathy Of Prematurity ◽  
Positive Response ◽  
Primary Treatment ◽  
Intravitreal Ranibizumab ◽  
Response Group ◽  
Type 1 Rop

Aim: To investigate the anatomic outcomes of patients treated with intravitreal ranibizumab in the treatment of type 1 retinopathy of prematurity (ROP). A prospective cohort study was done including 100 eyes of Material And Method: 60 patients with type 1 ROP treated with intravitreal injection of ranibizumab (IVR) (0.25 mg/ 0.025 ml) as primary treatment from June 2018 to November 2019 over a period of 18 months. The anatomic outcomes were analyzed and follow-up were done upto 6 months. There were a Result: total of 94 eyes (94.0%) in the positive response group and 6 eyes (6.0%) in the negative/no response group after IVR. Within the positive response group, 49 eyes (52.13%) were in the regression without laser subgroup, and 45 eyes (47.87%) were in the regression with laser subgroup. Conclusion: Intravitreal injection of ranibizumab seemed to be effective in treating patients with type 1 ROP.

scholarly journals Preferences and Trends in Practices Caring Premature Infants for Retinopathy of Prematurity (ROP): A Web-based Survey

2018 ◽  
Vol 1 (1) ◽  
pp. 49-61
Author(s):  
Swati Agarwal-Sinha ◽  
Sarina Amin ◽  
Amanda Way
Keyword(s):  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Practice Patterns ◽  
Treatment Preferences ◽  
Web Survey ◽  
Web Based ◽  
Type 1 Rop

Objectives: To study preferences in treatment, follow-up and conclusion of examination in infants treated with and without bevacizumab (IVB) and/or laser photocoagulation for retinopathy of prematurity (ROP).Methods: A 22 question web survey was administered to physicians to understand practice patterns for treatment of type1 ROP, determine timeframe of conclusion of examinations with and without IVB/laser, and to approximate incidence of ROP recurrence post-treatment.Results: The survey revealed that 73% pediatric ophthalmologists reported not personally performing injections and 54.1% reported not performing laser. In infants with persistent avascular retina without pre-threshold disease, 54.2% continued examination > 50 weeks PMA, 23.3% discontinued at 50 weeks PMA, 3.2% preferred prophylactic laser and 5.1% fluorescein angiography and laser prior to concluding exams. 46.3% of physicians preferred IVB as primary monotherapy, 37.3% laser, and 16.4% both IVB and laser in type 1 ROP. Of those who preferred IVB, 20.4% concluded examination at ? 55 weeks PMA, whereas 79.6% continued evaluation >55 weeks PMA (60 to ? 80 weeks). Of those who preferred both IVB and laser, 50.6% concluded examination at ? 50 weeks PMA, whereas 49.4% continued > 50 weeks (60 to ? 80 weeks). 21.1 % of respondents reported recurrence with IVB and 8.8% with dual therapyConclusions: Treatment preferences and conclusion of examination in ROP varies considerably without and with treatment. Though a longer follow-up is recommended with IVB, this survey reveals extended examinations beyond 50 weeks PMA in infants with persistent avascular retina requiring no treatment and in the laser treated subgroup. The survey highlights low rates of performing treatments personally by pediatric ophthalmologists, and distinctlyvariable practice patterns in ROP care

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