Structural, Visual and Refractive Outcomes of Intravitreal Aflibercept Injection in High-Risk Prethreshold Type 1 Retinopathy of Prematurity

Abdelrahman G. Salman; Aza M. Said

doi:10.1159/000364809

Strukturelle, visuelle und refraktive Verläufe der intravitrealen Injektion von Aflibercept bei Hochrisiko-Frühgeborenen-Prethreshold-Retinopathie vom Typ 1

Karger Kompass Ophthalmologie ◽

10.1159/000438802 ◽

2015 ◽

Vol 1 (2) ◽

pp. 84-86

Keyword(s):

High Risk ◽

Retinopathy Of Prematurity ◽

Intravitreale Injektion ◽

Multizentrische Studie ◽

Refractive Outcomes ◽

Intravitreal Aflibercept ◽

Zone Ii

Zielsetzung: Untersuchung der strukturellen, visuellen und refraktiven Ergebnisse der intravitrealen Injektion von Aflibercept in Monotherapie bei Patienten mit Frühgeborenenretinopathie (retinopathy of prematurity; ROP) vom Typ 1 mit hohem Risiko und unterhalb der Therapieschwelle. Aufbau: Prospektive, nichtrandomisierte, interventionelle Fallserien-Studie. Patienten und Methoden: Patienten mit Hochrisiko-Prethreshold-Typ-1-ROP wurden mit 1 mg/0,025 ml Aflibercept intravitreal behandelt. Die betrachteten primären Endpunkte waren ein ungünstiger struktureller Verlauf, ungünstiger visueller Verlauf und ungünstiger refraktiver Verlauf. Die sekundären Endpunkte waren ausbleibende Rezidivierung, okulare und systemische Nebenwirkungen. Ergebnisse: In die Studie wurden 26 Augen aufgenommen; alle hatten eine Nachbeobachtung von 1 Jahr abgeschlossen. Das mittlere Geburtsgewicht betrug 991 ± 266 g (Bereich 875-1105 g); das mittlere Gestationsalter bei Entbindung betrug 26,33 ± 2,1 Wochen (Bereich 24-30 Wochen); bei 9 Augen wurde die ROP als Stadium 2+, Zone I eingestuft, bei 14 Augen lag Stadium 3+ in Zone II vor und bei 3 Augen Stadium 3 in Zone I. 25 Augen (96,2%) zeigten einen günstigen strukturellen und 21 (80,1%) einen günstigen visuellen Verlauf; die Fehlsichtigkeit lag nach 1 Jahr im Median bei 0,75 dpt (Bereich -9,5 bis +4). Schlussfolgerungen: Die intravitreale Injektion von Aflibercept als Monotherapie ist eine einfache, sichere und wirksame Therapieoption bei Hochrisiko-Prethreshold-ROP vom Typ 1. Eine weitere, multizentrische Studie mit längerem Nachbeobachtungszeitraum ist erforderlich. Übersetzung aus Salman AG, Said AM: Structural, visual and refractive outcomes of intravitreal aflibercept injection in high-risk prethreshold type 1 retinopathy of prematurity. Ophthalmic Res 2015;53:15-20 (DOI: 10.1159/000364809)

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Effect of Intravitreal Aflibercept on Central Retinal Arterial Blood Flow in Type 1 Retinopathy of Prematurity

European Journal of Ophthalmology ◽

10.5301/ejo.5000938 ◽

2017 ◽

Vol 27 (6) ◽

pp. 751-755 ◽

Cited By ~ 2

Author(s):

Emine A. Sukgen ◽

Gökhan Söker ◽

Yusuf Koçluk ◽

Bozkurt Gülek

Keyword(s):

Blood Flow ◽

Retinopathy Of Prematurity ◽

Color Doppler ◽

Color Doppler Imaging ◽

Doppler Imaging ◽

Intravitreal Aflibercept ◽

Retinal Artery ◽

The Mean ◽

Type 1 Rop

Purpose To evaluate the blood flow changes of the central retinal artery measured with color Doppler imaging (CDI) in infants receiving intravitreal aflibercept (IVA) for treatment of type 1 retinopathy of prematurity (ROP). Methods Patients with type 1 ROP were assessed prospectively by CDI following IVA. Color Doppler imaging was used to measure the peak systolic velocity, end diastolic velocity (EDV), pulsatility index (PI), and resistivity index (RI) of the central retinal artery (CRA) before IVA injection and 1 hour, 1 week, and 1 month after injection. Results A total of 29 eyes of 15 infants were included in this study. The mean gestational age at birth was 28.62 ± 2.48 weeks and the mean birthweight was 1,198.62 ± 348.99 g. All treated eyes showed complete regression of ROP and peripheral retinal vascularization continued. Measurements of EDV-CRA, RI-CRA, and PI-CRA showed significant changes after IVA treatment. Conclusions This study showed that IVA is an effective treatment for type 1 ROP. After IVA treatment, vascular resistance increases, ocular blood flow decreases, and changes in hemodynamic parameters of CRA may remain for a month. Further studies are needed to evaluate the effect of anti-vascular endothelial growth factor agents on ocular hemodynamics in infants with ROP.

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Review of the latest treatments for retinopathy of prematurity: laser photo-ablation versus intravitreal anti-VEGF agents in the management of high-risk pre-threshold (type 1) disease

Expert Review of Ophthalmology ◽

10.1586/17469899.2015.1071190 ◽

2015 ◽

Vol 10 (5) ◽

pp. 421-430 ◽

Cited By ~ 1

Author(s):

Joshua Robinson ◽

Antonio Capone

Keyword(s):

High Risk ◽

Retinopathy Of Prematurity ◽

Anti Vegf ◽

Photo Ablation

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Transscleral vs transpupillary diode laser photocoagulation for the treatment of zone II type 1 retinopathy of prematurity: Anatomical and refractive outcomes

Indian Journal of Ophthalmology ◽

10.4103/ijo.ijo_1125_21 ◽

2022 ◽

Vol 70 (1) ◽

pp. 189

Author(s):

Nazanin Ebrahimiadib ◽

Ramak Roohipourmoallai ◽

Shahin Faghihi ◽

Hooshang Faghihi ◽

Ali Torkashvand ◽

...

Keyword(s):

Diode Laser ◽

Retinopathy Of Prematurity ◽

Laser Photocoagulation ◽

Refractive Outcomes ◽

Zone Ii

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Validation of the WINROP screening algorithm among preterm infants in East Malaysia

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v16i4.402 ◽

2019 ◽

Vol 16 (4) ◽

pp. 250-259

Author(s):

Nurhayati Abdul Kadir ◽

Syed Shoeb Ahmad ◽

Shuaibah Abdul Ghani ◽

Mae-Lyn Catherine Bastion

Keyword(s):

High Risk ◽

Preterm Infants ◽

Retinopathy Of Prematurity ◽

Tertiary Care ◽

Time Lag ◽

Low Risk ◽

Screening Algorithm ◽

East Malaysia ◽

Type 1 Rop

Objective: To prospectively validate the WINROP (Weight, Insulin-like growth factor 1, Neonatal, Retinopathy of Prematurity) screening algorithm (www.winrop.com) based on longitudinal measurements of neonatal body weights in predicting the development of severe retinopathy of prematurity (ROP) among preterm infants admitted to the neonatal intensive care unit of a tertiary care center in East Malaysia. Methods: All premature infants of less than 32 weeks gestational age (GA) were included in this cohort. Their body weight was measured weekly from birth to 36 weeks postmenstrual age and entered into the computer-based surveillance system: WINROP. Infants were then classified by the system into high- or low-risk alarm group. The retinopathy findings were recorded according to Early Treatment for ROP criteria. However, the screening and management of infants were done according to the recommendations of the Continuous Practice Guidelines, Ministry of Health, Malaysia. The team members involved in screening and those recording the findings were kept blinded from each other. Results: A total of 151 infants with median GA at birth of 30 weeks (interquartile range [IQR] Å} 2.1) and mean birth weight of 1,264 g (standard deviation Å} 271) were analyzed. High-risk alarm was signaled in 85 (56.3%) infants and 9 (6.6%) infants developed type 1 ROP. One infant in the low-risk alarm group developed type 1 ROP requiring laser retinal photocoagulation. The median time lag from the high-risk alarm signal to the development of type 1 ROP was 10.4 (IQR Å} 8.4) weeks. Conclusion: In this cohort, the WINROP algorithm had a sensitivity of 90%, with negative predictive value of 98.5% (95% confidence interval) for detecting infants with type 1 ROP and was able to predict infants with ROP earlier than their due screening date. This study shows that a modified version of the WINROP algorithm aimed at specific populations may improve the outcome of this technique.

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ANATOMICAL AND FUNCTIONAL RESULTS OF INTRAVITREAL AFLIBERCEPT MONOTHERAPY FOR TYPE 1 RETINOPATHY OF PREMATURITY

Retina ◽

10.1097/iae.0000000000002754 ◽

2020 ◽

Vol 40 (12) ◽

pp. 2366-2372 ◽

Cited By ~ 1

Author(s):

Yen-Ting Chen ◽

Laura Liu ◽

Chi-Chun Lai ◽

Kuan-Jen Chen ◽

Yih-Shiou Hwang ◽

...

Keyword(s):

Retinopathy Of Prematurity ◽

Functional Results ◽

Intravitreal Aflibercept

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Apoptosis and proliferation ofperipheral blood T-cells as alternative processes in pathogenesis of diabetes mellitus type 1

Medical alphabet ◽

10.33667/2078-5631-2019-1-4(379)-16-20 ◽

2019 ◽

Vol 1 (4) ◽

pp. 16-20 ◽

Cited By ~ 1

Author(s):

A. V. Lugovaya ◽

N. M. Kalinina ◽

V. Ph. Mitreikin ◽

Yu. P. Kovaltchuk ◽

A. V. Artyomova ◽

...

Keyword(s):

Diabetes Mellitus ◽

T Cells ◽

High Risk ◽

Peripheral Blood ◽

Cellular Response ◽

Proliferative Potential ◽

Autoreactive T Cells ◽

Alternative Processes

Apoptosis, along with proliferation, is a form of lymphocyte response to activating stimuli. In the early stages of cell differentiation, the apoptotic response prevails and it results to the formation of tolerance to inductor antigen. Mature lymphocytes proliferate in response to stimulation and it means the initial stage in the development of the immune response. Since in this case apoptosis and proliferation acts as alternative processes, their ratio can serve as a measure of the effectiveness of the cellular response to activating signals. The resistance of autoreactive T-cells to apoptosis is the main key point in the development of type 1 diabetes mellitus (T1DM). Autoreactive T-cells migrates from the bloodstream to the islet tissue of the pancreas and take an active part in b cells destruction. The resistance of autoreactive effector T-cells to apoptosis may suggest their high proliferative potential. Therefore, the comparative evaluation of apoptosis and proliferation of peripheral blood lymphocytes can give a more complete picture of their functional state and thus will help to reveal the causes of ineffective peripheral blood T-ceiis apoptosis in patients with T1DM and will help to understand more deeply the pathogenesis of the disease. in this article, the features of proliferative response of peripheral blood T-cells in patients with T1DM and in individuals with high risk of developing T1DM have been studied. Apoptosis of T-cell subpopulations has been investigated. The correlation between the apoptotic markers and the intensity of spontaneous and activation- induced in vitro T-cells proliferation of was revealed. it was determined, that autoreactive peripheral blood T-cells were resistant to apoptosis and demonstrated the increased proliferative potential in patients with T1DM and in individuals with high risk of developing T1DM.

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