A proposal of an algorithm for the diagnosis and treatment of recurrence or treatment failure of retinopathy of prematurity after anti-VEGF therapy based on a large case series

Martínez-Castellanos, María Ana; González-H.León, Ana; Romo-Aguas, Juan C.; González-González, Luis

doi:10.1007/s00417-020-04605-y

Cited by 26 publications

(17 citation statements)

References 12 publications

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“…The art of managing IVB-treated ROP patients is to differentiate treatment failure from recurrence, chie y because the mainstream of treatment failures signi es a misdiagnosis. 11 Currently, evidence on response patterns to IVB, primary failure rate, and risk factors are scarce. Chen and colleagues described a spectrum of regression, including full vascular maturity, vascular arrest alone, or vascular arrest with persistent tortuosity following injection of bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

“…Due to potential long-term sequelae of the disease, and based on which anti-VEGF administration, recurrence can occur by delay in anti-VEGF monotherapy of ROP patients. 11 In light of the abovementioned studies, early detection of primary failure and recurrence after intravitreal administration of anti-VEGF is essential to provide vigilant follow-up to ensure timely retreatment. We present the results of large case series of ROP-treated infants treated with intravitreal Bevacizumab to report the rate of primary failure and recurrence in these patients and the timing of recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence

et al. 2022

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Purpose: This study aimed To evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP).Methods: This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal Bevacizumab from 2012 to 2019. Medical records of patients were evaluated.Results: Mean gestational age (GA) and birth weight of patients were 28±2 weeks and 1121±312 g, respectively. Thirty-ve eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64±13.68 days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis.The recurrence occurred in 33 eyes (3.97 %) of them in 20 patients, with the meantime of 77.52 days after the rst treatment (IVB). Presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with signi cantly increased prevalence of treatment failure. The risk factor predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis.Conclusion: Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Attention to risk factors accompanied by special care to patterns of treatment failure and recurrence helps to achieve early detection of treatment failure and vigilant follow up for recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence

et al. 2022

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“…In terms of disease recurrence, multiple studies have found that comparing with photocoagulation, the average recurrence time of retinopathy treated with IVB is about 10 weeks later. Therefore, it is suggested that for the treatment of ROP with IVB, the follow-up time should be longer, so as to detect the recurrence of the disease [20][21]. The three groups of patients in this study were all nonlocal and could not adhere to the long-term follow-up, so they only followed up to the 3 rd month after treatment, and then followed up in the local hospital.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Analysis of Ocular Fundus Changes After Different Doses of Bevacizumab in the Treatment of Retinopathy of Prematurity in Threshold Period

Chen

Xiang

et al. 2021

Preprint

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Purpose: To analyze the efficacy of three different doses of bevacizumab treatment on Threshold retinopathy of prematurity during different periods . Methods: 36 cases (72 eyes) of infants with threshold ROP were analyzed, whom were treated with intravitreal injection of 1.25 mg, 0.75 mg or 0.5 mg bevacizumab respectively from October 1st, 2016 to September 30th, 2017. After treatment, fundus examination results during five time points were recorded and classified into four grades according to the efficacy. Results: There were significant differences in the changes of fundus among the 3 groups from the 4th day to the 4th week after treatment （P<0.01）. In the 1.25 mg group, there was a significant difference in the changes of fundus on the 4th day after treatment VS. the 2nd week after treatment (P<0.001). In the 0.75 mg and 0.5 mg group respectively, the changes of fundus were significantly different between each consecutive time points of the 4th day, 2nd week, 4th week and 2nd month after treatment (P<0.001,P=0.001,P=0.002; P<0.001,P=0.001,P=0.003). The proportion of normal retinal vessels respectively in 1.25 mg , 0.75 mg and 0.5 mg group is 66.67%、43.48% and 50% in the 3rd month after treatment.Conclusion: Retinal complete vascularization was slightly better in 1.25 mg group, but failed to reach a statistical significance. Based on results, the lowest dose 0.5 mg may be preferred since our final results were similar (p>0.05). Long-term follow-up of fundus changes was still needed to avoid recurrence of ROP whatever the dose of bevacizumab was uesed.

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“…Anti-VEGF therapy is considered to be one of the most effective treatment options for DR and wet-AMD and is frequently used off label to treat ROP [11][12][13][14][15]. Current FDA approved anti-VEGF agents include bevacizumab, ranibizumab, and aflibercept, which are administered via monthly or bi-weekly intravitreal injections [14,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

High Density Display of an Anti-Angiogenic Peptide on Micelle Surfaces Enhances Their Inhibition of αvβ3 Integrin-Mediated Neovascularization In Vitro

Nagaraj

Stack

et al. 2020

Nanomaterials

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Diabetic retinopathy (DR), Retinopathy of Pre-maturity (ROP), and Age-related Macular Degeneration (AMD) are multifactorial manifestations associated with abnormal growth of blood vessels in the retina. These three diseases account for 5% of the total blindness and vision impairment in the US alone. The current treatment options involve heavily invasive techniques such as frequent intravitreal administration of anti-VEGF (vascular endothelial growth factor) antibodies, which pose serious risks of endophthalmitis, retinal detachment and a multitude of adverse effects stemming from the diverse physiological processes that involve VEGF. To overcome these limitations, this current study utilizes a micellar delivery vehicle (MC) decorated with an anti-angiogenic peptide (aANGP) that inhibits αvβ3 mediated neovascularization using primary endothelial cells (HUVEC). Stable incorporation of the peptide into the micelles (aANGP-MCs) for high valency surface display was achieved with a lipidated peptide construct. After 24 h of treatment, aANGP-MCs showed significantly higher inhibition of proliferation and migration compared to free from aANGP peptide. A tube formation assay clearly demonstrated a dose-dependent angiogenic inhibitory effect of aANGP-MCs with a maximum inhibition at 4 μg/mL, a 1000-fold lower concentration than that required for free from aANGP to display a biological effect. These results demonstrate valency-dependent enhancement in the therapeutic efficacy of a bioactive peptide following conjugation to nanoparticle surfaces and present a possible treatment alternative to anti-VEGF antibody therapy with decreased side effects and more versatile options for controlled delivery.

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A proposal of an algorithm for the diagnosis and treatment of recurrence or treatment failure of retinopathy of prematurity after anti-VEGF therapy based on a large case series

Cited by 26 publications

References 12 publications

Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence

Intravitreal bevacizumab to treat retinopathy of prematurity in 865 eyes: a study to determine predictors of primary treatment failure and recurrence

Dynamic Analysis of Ocular Fundus Changes After Different Doses of Bevacizumab in the Treatment of Retinopathy of Prematurity in Threshold Period

High Density Display of an Anti-Angiogenic Peptide on Micelle Surfaces Enhances Their Inhibition of αvβ3 Integrin-Mediated Neovascularization In Vitro

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