Does Anti-Vascular Endothelial Growth Factor Treatment Delay Photoreceptor Maturation in Preterm Infants?

Abstract

Purpose: To investigate the effects of intravitreal anti-vascular endothelial growth factor (VEGF) for treatment of type-1 or aggressive posterior retinopathy of prematurity (ROP) on photoreceptor maturation in preterm infants using spectral domain optical coherence tomography (SD-OCT). Methods: A study group of 36 patients with ROP treated with anti-VEGF therapy was compared to a control group of 80 patients with ROP. All patients had undergone SD-OCT imaging at least once between 40 and 44 weeks post-menstrual age (PMA). Two imaging specialists evaluated the images for ellipsoid zone (EZ) development, cystoid macular edema (CME), sub-retinal fluid (SRF) at the fovea, and cone outer segment tips (COST). The outer nuclear layer thickness and the distance from the EZ to the central fovea was measured. Results: EZ development was observed in 18 (50%) patients in the study group and 68 (85%) in the control group (p = 0.002). CME was observed in 17 (47.2%) patients in the study group and 17 (21.2%) in the control group. The distance between the EZ and central fovea was 868 ± 440 µm in the study group and 725 ± 380 µm in the control group (p = 0.02). COST was not observed in any patient. Regression analysis indicated that anti-VEGF treatment and CME affect EZ development. Conclusıons: Early photoreceptor maturation is correlated with preterm birth week but not ROP stage. Anti-VEGF treatment delays photoreceptor maturation in preterm infants.