Efficacy of intravitreal aflibercept monotherapy in retinopathy of prematurity evaluated by periodic fluorescence angiography and optical coherence tomography

Vural, Aslı; Perente, İrfan; Onur, İsmail Umut; Eriş, Erdem; Seymen, Zeynep; Hergünsel, Gülsüm Oya; Salihoğlu, Özgül; Yigit, Fadime Ulviye

doi:10.1007/s10792-018-1040-x

Cited by 25 publications

(31 citation statements)

References 28 publications

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“…The RAINBOW study used ranibizumab, which is cleared more rapidly from the blood and eye, compared to laser 36 , and the PEDIG ROP1 studies tested de-escalating doses of bevacizumab to find an effective and safe dose 37 . Studies through Regeneron are also testing the effect of aflibercept 38 to laser in type 1 ROP.…”

Section: Clinical Evidencementioning

confidence: 99%

Retinopathy of Prematurity: Evolving Treatment With Anti–Vascular Endothelial Growth Factor

Hartnett

2020

American Journal of Ophthalmology

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Purpose: To discuss the evolution in retinopathy of prematurity (ROP) since its first description as retrolental fibroplasia in the US, including the changes in the understanding of pathophysiology; methods of diagnosis; destructive, anti-VEGF, and supportive treatments; and differences in ROP manifestations worldwide. The overall goal is to clarify ROP currently and formulate questions to optimize future care. Study Design: Literature Review and SynthesisMethods: Critical review and consideration of the literature with inclusion of historical articles and those regarding pathophysiologic risk factors, ROP worldwide, basic and clinical science particularly regarding anti-VEGF mechanisms and agents tested in clinical trials.Results: ROP has evolved from affecting infants about 2 months premature to affecting extremely premature infants. Worldwide, ROP differs and in emerging countries, has features similar to that experienced in the US when ROP first manifested. Treatments have evolved from destruction of the peripheral avascular retina to inhibit angiogenic stimuli to anti-VEGF agents, which inhibit pathologic angiogenesis but also extend normal intraretinal angiogenesis by ordering the development of intraretinal vessels. Clinical trial evidence is accruing with the goal to develop less destructive treatments to optimize vision and that are protective to the retina and infant.Conclusions: Goals for ROP are to optimize prenatal and perinatal care, improve diagnostic acumen worldwide and refine treatment strategies, including with anti-VEGF agents, to inhibit intravitreal angiogenesis and facilitate vascularization of the previously avascular retina, which include supporting neural and vascular development of the premature infant and retina.

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Section: Clinical Evidencementioning

confidence: 99%

Retinopathy of Prematurity: Evolving Treatment With Anti–Vascular Endothelial Growth Factor

Hartnett

2020

American Journal of Ophthalmology

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“…Vural 49 conducted a retrospective study in 36 eyes with type 1 ROP and APROP treated with Aflibercept as primary therapy. At the first week was observed regression of ROP in 94.4% of study population; only 5.5% was reinjected.…”

Section: Efficacymentioning

confidence: 99%

New trends in intravitreal anti-VEGF therapy for ROP

Beccasio

Mignini

Caricato

et al. 2022

European Journal of Ophthalmology

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Retinopathy of Prematurity (ROP) affects premature newborns, and it can cause childhood blindness and visual impairment if untreated. The understanding of the pathogenetic role of Vascular Endothelial Growth Factor (VEGF) has led to development of therapeutic strategies such as intravitreal anti-VEGF drugs. We reported drug efficacy and ROP recurrence rates, extrapolated from the reviewed studies. Association of Pegabtanib and laser photocoagulation confers efficacy in the regression of ROP stage 3 plus in zone I / II in 89.7% of treated eyes, reducing the recurrence rate to 14.6% compared to 50% of laser therapy alone. Irrespective of the dose, Ranibizumab demonstrated average efficacy greater than 75% on regression of active disease with the highest rates of the dose of 0.1 mg (92.5%). The recurrence, on the other hand, is the highest among this new anti-VEGF agents and is around an average of 41.5%, which records the highest values in the case of Aggressive Posterior Rop (APROP). Aflibercept at a dose of 1 mg demonstrated average efficacy of about 81.9% of treated infants, analyzing significantly fewer studies than Ranibizumab. The recurrence rate stands at an average of 28.9%, especially in the later forms of ROP. Using a dose of 0.25 mg of Conbercept, the disease regression rate is currently on average 83%, with an average recurrence rate of 15.24%, the peak of which was observed in cases of ROP in zone I. Further studies are needed to prove safety at long term, because,at the moment, only short-term data are available.

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“…Intravitreal aflibercept (IVA) is a fusion protein (115 kDa) that binds multiple isoforms of human VEGF-A, VEGF-B, and placental growth factor [ 50 ]. IVA has been used for ROP in numerous reports [ 35 , 51 , 52 ], and is currently being compared to primary laser therapy via a study (NCT04101721) through Regeneron (BUTTERFLEYE).…”

Section: Treatment: Anti-vascular Endothelial Growth Factor (Anti-vegf) Therapy For Type 1 Ropmentioning

confidence: 99%

80 Years of vision: preventing blindness from retinopathy of prematurity

Wood

Chang

Beck³

et al. 2021

J Perinatol

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Efficacy of intravitreal aflibercept monotherapy in retinopathy of prematurity evaluated by periodic fluorescence angiography and optical coherence tomography

Cited by 25 publications

References 28 publications

Retinopathy of Prematurity: Evolving Treatment With Anti–Vascular Endothelial Growth Factor

Retinopathy of Prematurity: Evolving Treatment With Anti–Vascular Endothelial Growth Factor

New trends in intravitreal anti-VEGF therapy for ROP

80 Years of vision: preventing blindness from retinopathy of prematurity

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