Comparison of Bevacizumab and Ranibizumab in the Treatment of Type 1 Retinopathy of Prematurity Affecting Zone 1

Abstract

Purpose: To investigate the effects of bevacizumab and ranibizumab in the treatment of type 1 retinopathy of prematurity (ROP) affecting zone 1. Methods: Files of the patients who received intravitreal bevacizumab (IVB) or ranibizumab (IVR) treatment for ROP affecting zone 1 were evaluated retrospectively. Spherical equivalent (SE) and axial length (AXL) measurements were performed at 1 year of adjusted age. Results: Sixty-eight eyes of 37 patients were included in the study. All patients had initial disease regression but 6 patients (4 in the IVB, 2 in the IVR group) showed reactivation (p = 0.679). The number of eyes with incomplete vascularization were 15 and 12 in the IVB and IVR groups, respectively (p = 0.725). Mean AXL was 20.50 ± 0.99 mm in the IVB group and 19.30 ± 0.48 mm in the IVR group (p < 0.001). Mean SE was –1.49 ± 2.38 dpt in the IVB group and 0.98 ± 2.18 dpt in the IVR group (p < 0.001). Conclusion: Bevacizumab and ranibizumab showed similar effectiveness in the treatment of type 1 ROP affecting zone 1. The AXL was longer and SE was more myopic in eyes treated with IVB. This difference might be caused by the longer intravitreal half-life of bevacizumab than ranibizumab.

Development of refractive error in children treated for retinopathy of prematurity with anti-vascular endothelial growth factor (anti-VEGF) agents: A meta-analysis and systematic review

“…However, very limited refractive error information exists in IVR-treated patients. Moreover, limited literature reported inconsistent conclusions on whether refractive error development differed in infants treated with IVR and those treated with IVB [13, 23, 25, 26]. Other anti-VEGF agents such as aflibercept [58] and conbercept [59, 60] have also been used to treat ROP.…”

Two-Year Outcomes of Infants with Stage 2 or Higher Retinopathy of Prematurity: Results from a Large Multicenter Registry

“…One strength of this study was the decision to include all infants with stage 2 or higher ROP rather than limiting longterm follow-up to only those patients requiring treatment. Many ROP clinical trials 3,10,14,26 only completed follow-up for infants who were treated. As a result, there is a paucity of data about visual outcomes for the majority of infants who regress before they reach threshold for treatment.…”

“…Widespread uncertainty remains about the optimal treatment for ROP. [2][3][4][10][11][12][13] Laser surgery has largely replaced cryotherapy, but concerns persist about the permanent destruction of the peripheral retina that accompanies this mode of therapy. The introduction of intravitreal bevacizumab may avoid this retinal damage, but long-term outcomes are only known for the small number of patients enrolled in the initial trials, 3,11,14,15 and there are potential concerns about adverse neurodevelopmental outcomes in infants treated with bevacizumab for ROP.…”

Efficacy of Aflibercept Treatment and Its Effect on the Retinal Perfusion in the Oxygen-Induced Retinopathy Mouse Model of Retinopathy of Prematurity

“…Medical care to prevent blindness secondary to ROP has gained attention globally in the last decade with the increased use of anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections (bevacizumab, ranibizumab, and aflibercept) as the primary mode of treatment for type 1 ROP over traditional laser photocoagulation to the avascular retina [2]. There are numerous clinical studies which highlight the efficacy of anti-VEGF injections in the treatment of ROP [3-6]. Although bevacizumab is used widely in the treatment of type 1 ROP due to its low cost compared with other anti-VEGF medications, there are published studies on the efficacy of ranibizumab and aflibercept in neonates with promising results [4-9].…”