scholarly journals Refractive errors in premature infants with retinopathy of prematurity after anti-vascular endothelial growth factor (anti-VEGF) therapy

2017 ◽  
Vol 74 (4) ◽  
pp. 323-328
Author(s):  
Milena Vujanovic ◽  
Gordana Stankovic-Babic ◽  
Ana Oros ◽  
Gordana Zlatanovic ◽  
Predrag Jovanovic ◽  
...  
Keyword(s):  
Growth Factor ◽  
Premature Infants ◽  
Retinopathy Of Prematurity ◽  
High Myopia ◽  
Control Group ◽  
Study Group ◽  
Refractive Errors ◽  
Anti Vegf ◽  
Significant Difference ◽  
Endothelial Growth Factor

Background/Aim. Retinopathy of prematurity (ROP) is a vasoproliferative retinopathy which affects the blood vessels of the retina during its development. The aim of this study was to evaluate the incidence and the degree of refractive errors in premature infants with severe ROP treated with antivascular endothelial growth factor (anti-VEGF) (bevacizumab). Methods. This prospective study included 21 patients (42 eyes) nine months old who received intravitreal injection of anti-VEGF therapy. The control group consisted of 45 patients (90 eyes) who were subjected to laser treatment. In cycloplegia each patient underwent retinoscopy, keratorefractometry, and A-scan ultrasonography. Results. Myopia was present in 47.62% of the eyes in the study group and in 33.33% of the eyes in the control group, but there were no statistically significant differences between these groups. Seven (16.67%) eyes in the study group and 17 (18.89%) eyes in the control group were discovered to have high myopia (SE? spherical equivalents < -3.0 D ? dioptre). Clinically significant hypermetropia was higher in the study group (47.62%) than in the control group (34.44%), but with no statistically significant difference. In addition, high hypermetropia was significantly greater in the control group (15.56%) than in the study group (11.90%) (p < 0.001). Astigmatism was more common in the control group than in the study group (81.11% vs 71.43%, respectively), especially high astigmatism (56% vs 43%, respectively). Also the more common form of astigmatism was with the rule (WTR) both in the study and the control group (42.86% vs 55.56%, respectively). Anisometropia was significantly greater in the control group (24.44%) than in the study group (9.52%) (p < 0.05). The children from the study group had significantly greater lens thickness, and a shorter anterior chamber depth than children from the control group (p < 0.01). There was no significant difference in the axial length of the eye between the groups. Conclusion. At the 9-month follow-up myopia was present in the patients with severe ROP treated with anti-VEGF, but high myopia was present to a lesser degree than in the laser treated patients. This difference is possibly related to anterior segment development. Research into the longer-term refractive outcomes is necessary with observation of the biometric components, visual acuity, and the visual field in order to monitor the real effects of this therapy.

scholarly journals Refractive outcomes after intravitreal injection of antivascular endothelial growth factor versus laser photocoagulation for retinopathy of prematurity: a meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042384
Author(s):  
Qihang Kong ◽  
Wai-kit Ming ◽  
Xue-Song Mi
Keyword(s):  
Growth Factor ◽  
Laser Therapy ◽  
Retinopathy Of Prematurity ◽  
Data Extraction ◽  
Meta Analysis ◽  
Refractive Errors ◽  
Anti Vegf ◽  
Refractive Status ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

ObjectiveTo determine the effects of the intraocular injection of antivascular endothelial growth factor (anti-VEGF) drugs on the refractive status of infants with retinopathy of prematurity (ROP).DesignSystematic review and meta-analysis of the refractive status of infants with ROP who receive anti-VEGF drugs.Data sourcesThe PubMed, Web of Science and Embase databases and the ClinicalTrials.gov website were searched up to June 2020.Eligibility criteria when selecting studiesWe included randomised controlled trials (RCTs) and observational studies that compared refractive errors between anti-VEGF drug and laser therapies.Data extraction and synthesisData extraction and risk-of-bias assessments were conducted by two independent reviewers. We used a random-effect model to pool outcomes. The outcome measures were the spherical equivalents, axial length (AL), anterior chamber depth (ACD) and lens thickness (LT).ResultsThirteen studies involving 1850 eyes were assessed: 914 in the anti-VEGF drug group, and 936 in the control (laser) group. Children who received anti-VEGF drug treatment had less myopia than those who received laser therapy (mean difference=1.80 D, 95% CI 0.97 to 2.63, p＜0.0001, I2=78%). The AL, ACD and LT did not reach statistical significance difference between the two groups. The current evidence indicates that the refractive safety in children with ROP is better for anti-VEGF drug treatment than for laser therapy.ConclusionsThis meta-analysis indicates that anti-VEGF drug therapy results in less myopia compared with laser therapy. However, there are relatively few published articles on refractive errors in ROP, and so high-quality and powerful RCTs are needed in the future.PROSPERO registration numberCRD42020160673.

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 The Distribution of Vascular Endothelial Growth Factor (VEGF), Human Beta-Defensin-2 (HBD-2), and Hepatocyte Growth Factor (HGF) in Intra-Abdominal Adhesions in Children under One Year of Age

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Anna Junga ◽  
Māra Pilmane ◽  
Zane Ābola ◽  
Olafs Volrāts
Keyword(s):  
Growth Factor ◽  
Control Group ◽  
Relative Distribution ◽  
Abdominal Adhesions ◽  
Related Factors ◽  
Hypoxic Conditions ◽  
Significant Difference ◽  
Group A ◽  
One Year ◽  
Endothelial Growth Factor

The regulatory role between ischemia related factors and antimicrobial peptides in congenital intra-abdominal adhesions has not yet been defined. The aim of this research was to investigate the appearance and relative distribution of VEGF, HBD-2, and HGF in congenital intra-abdominal adhesions compared with relatively healthy tissue controls. The study group material was obtained from 48 patients who underwent abdominal surgery due to partial or complete bowel obstruction. VEGF, HBD-2, and HGF were detected using immunohistochemistry methods and their relative distribution was evaluated by means of the semiquantitative counting method. The results were analyzed using nonparametric statistic methods. A moderate number of VEGF positive endotheliocytes were detected, but there was no statistically significant difference between the groups. In the experimental group, a moderate to high number of VEGF positive macrophages was observed. In control group tissues, such macrophages were seen in significantly lower number (U = 61.0, p = 0.001). The increase of VEGF positive cells indicates support of angiogenesis due to the hypoxic conditions in case of adhesion disease. The number of HBD-2 marked fibroblasts and macrophages was moderate to high, but only few positive endotheliocytes were observed. Persisting appearance of HBD-2 positive structures might be a result of the inflammatory process. Most specimens showed occasional HGF positive macrophages and fibroblasts and there was no statistically significant difference between the groups. The relatively weak appearance of HGF suggests that the lack of this factor promotes the formation of fibrotic changes in case of intra-abdominal adhesions.

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 Healthcare resource use and costs of diabetic macular oedema for patients with antivascular endothelial growth factor versus a dexamethasone intravitreal implant in Korea: a population-based study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030930 ◽  
Author(s):  
HyunJeong Cho ◽  
Kyung Seek Choi ◽  
Joo Yong Lee ◽  
Donghwan Lee ◽  
Nam-Kyong Choi ◽  
...  
Keyword(s):  
Growth Factor ◽  
Healthcare Resource ◽  
Diabetic Macular Oedema ◽  
Eye Care ◽  
Dexamethasone Intravitreal Implant ◽  
Anti Vegf ◽  
Significant Difference ◽  
Intravitreal Implant ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

ObjectivesTo estimate the costs and healthcare resources of patients with diabetic macular oedema (DME) who received intravitreal antivascular endothelial growth factor (anti-VEGF) agents or a dexamethasone intravitreal implant (DEX-implant) in Korea.DesignRetrospective cohort study.SettingThe Korean National Health Insurance claim data from 1 January 2015 to 30 June 2017 were retrieved from the Health Insurance Review and Assessment Service.ParticipantsAdult patients with DME who were diagnosed with diabetic retinopathy or DME and received ranibizumab, aflibercept or a DEX-implant in conjunction with intravitreal injection were included. Patients whose primary diagnoses were age-related macular degeneration or retinal vein occlusion were excluded.Main outcome measuresHealthcare resource utilisation and costs related to DME in the 12-month postindex period.ResultsDuring the study period, 182 patients and 414 patients were identified in the anti-VEGF and DEX-implant groups, respectively, and there was no significant difference in the demographic characteristics between the two groups. The outpatient eye care-related medical costs were US$3002.33 for the anti-VEGF group vs US$2250.35 for the DEX-implant group (p<0.0001). After adjusting the relevant covariates based on the generalised linear model, the estimated outpatient eye care-related medical costs were 33% higher in the anti-VEGF group than in the DEX-implant group (p<0.0001, 95% CI 22% to 45%). The utilisation pattern of the two groups showed no significant difference except for the number of intravitreal injections, which was higher in the anti-VEGF group (2.69±2.29) than in the DEX-implant group (2.09±1.37, p<0.001).ConclusionThe average annual eye-related medical cost of the DEX-implant group was significantly lower than that of the anti-VEGF group during the study period, which was mainly due to decreased utilisation of eye care-related injections. Further long-term studies are needed.

Choroidal neovascularisation in a predicted female choroideraemia carrier treated with intravitreal anti-vascular endothelial growth factor

2021 ◽  
Vol 31 (1_suppl) ◽  
pp. 4-10
Author(s):  
Juan Lyn Ang ◽  
Alan F. Wright ◽  
Baljean Dhillon ◽  
Peter Cackett
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
High Myopia ◽  
Vision Loss ◽  
Choroidal Neovascularisation ◽  
First Episode ◽  
Carrier Status ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Endothelial Growth Factor

Purpose: To report a case of choroidal neovascularisation and leakage in a myopic female predicted to be a choroideraemia carrier treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF). Methods: Case report. Results: A female magazine editor presented with sudden decrease in vision in her right eye, with Snellen visual acuities (VAs) of 1/60 and 3/60 in the right and left eyes respectively. She was diagnosed with choroidal neovascularisation (CNV) formation and subretinal haemorrhage in her right eye. This is on a background of previous presentations, the first of which was 20 years ago for declining left eye vision. She was subsequently found to be a predicted choroideraemia carrier. However, she also has high myopia, and it is unclear whether the predicted choroideraemia carrier status or high myopia is the main underlying cause of her CNV, although we believe that the former is more likely. The first episode of CNV in her right eye was treated successfully with intravitreal anti-VEGF. However, she experienced four further CNV reactivations in her right eye, all of which were treated successfully with anti-VEGF. At her last follow-up visit to date, Snellen VAs were 6/9 and 3/60 in her right and left eye respectively. Conclusion: This is a unique case of CNV formation in a predicted choroideraemia carrier who also has co-existent high myopia. Prompt treatment of CNV activity with anti-VEGF has been efficacious in prevention of subretinal fibrosis and irreversible vision loss and allowed the patient to continue working in her chosen career.

scholarly journals Impact of macular fluid features on outcomes of anti-vascular endothelial growth factor treatment for type 3 macular neovascularization

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wontae Yoon ◽  
Jihyun Yoon ◽  
Seung Kwan Na ◽  
Jihyun Lee ◽  
Jaemin Kim ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Growth Factor ◽  
Vascular Endothelial ◽  
Anti Vegf ◽  
Significant Difference ◽  
Type 3 ◽  
Endothelial Growth Factor ◽  
The Impact ◽  
Anatomical Outcomes

AbstractWe evaluated the impact of macular fluid features on visual and anatomical outcomes in type 3 macular neovascularization (MNV) patients treated with anti-vascular endothelial growth factor (VEGF). We retrospectively enrolled 89 eyes with type 3 MNV with at least 12 months of follow-up. All patients were treatment-naïve and received a monthly loading injection of anti-VEGF for three months, followed by further injections as required. The association of baseline macular morphology, including intraretinal fluid (IRF) and subretinal fluid (SRF), with visual and anatomical outcomes was analyzed. At baseline, IRF was present in all enrolled patients (100%), and SRF was present in 43.8% (39/89) of them. After 12 months of treatment, no significant difference was found in terms of best-corrected visual acuity (BCVA) and changes in central foveal thickness between the eyes with (39) and without (50) SRF at baseline. In addition, the proportion of improved or worsened (gain or loss of more than three lines in the BCVA) visual acuity at 12 months was not significantly different among the groups. Incidence of macular atrophy during the treatment showed no difference between the groups, regardless of the presence of SRF. In conclusion, the macular fluid morphology, specifically SRF, in type 3 MNV showed no significant correlation with visual and anatomical outcomes during anti-VEGF treatment.

scholarly journals Vascular endothelial growth factor inhibitors for retinopathy of prematurity

2020 ◽  
Vol 20 (4) ◽  
pp. 216-220
Author(s):  
O.V. Zhukova ◽  
◽  
I.A. Mal’tseva ◽  
A.V. Zolotarev ◽  
◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Retinopathy Of Prematurity ◽  
Treatment Modalities ◽  
Vascular Endothelial ◽  
Intravitreal Ranibizumab ◽  
Vegf Inhibitors ◽  
Anti Vegf ◽  
Endothelial Growth Factor ◽  
Retinal Photocoagulation

The article addresses current treatment modalities for threshold retinopathy of prematurity (ROP) and aggressive posterior retinopathy of prematurity (APROP), in particular, intravitreal administration of vascular endothelial growth factor (VEGF) inhibitors. The results of multicenter clinical trials evaluating pegaptanib, bevacizumab, and ranibizumab are discussed. The clinical effect of intravitreal anti-VEGF drugs was compared to the efficacy of laser retinal photocoagulation. In children with ROP, anti-VEGF drugs are equal or even superior to the conventional laser retinal photocoagulation in terms of clinical efficacy. No negative effects of anti-VEGF drugs on ocular tissues or vasculature development in premature children were demonstrated. Moreover, several studies show the potential efficacy of intravitreal anti-VEGF drugs plus avascular zone photocoagulation for APROP. Finally, our experience with intravitreal ranibizumab for threshold ROP and plus disease in a patient who was followed-up for subsequent 9 years is described.Keywords: retinopathy of prematurity, plus disease, aggressive posterior retinopathy of prematurity, anti-VEGF drugs, ranibizumab.For citation: Zhukova O.V., Mal’tseva I.A., Zolotarev A.V. Vascular endothelial growth factor inhibitors for retinopathy of prematurity. Russian Journal of Clinical Ophthalmology. 2020;20(4):216–220. DOI: 10.32364/2311-7729-2020-20-4-216-220.

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