Efficacy of intravitreal injection of bevacizumab for severe retinopathy of prematurity: a pilot study

Shima, Chiharu; Wada, Kazuko; Arahori, Hitomi; Shimojyo, Hiroshi; Sato, Tatsuhiko; Fujikado, Takashi

doi:10.1136/bjo.2008.140657

Cited by 147 publications

(80 citation statements)

References 28 publications

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“…In the second phase, which follows oxygeninduced vessel loss and subsequent hypoxia, retinal VEGF expression is induced, resulting in pathological neovascularization. Intravitreal injection of VEGF inhibitors during this phase decreases the neovascular response, indicating that VEGF is a critical factor contributing to retinal vascularization (3,8). Excessive VEGF production and aberrant neoangiogenesis have also been implicated in retinal neovascularization in diabetic retinopathy (9) and choroidal neovascularization in AMD (10).…”

mentioning

confidence: 99%

Genetic and pharmacological inhibition of JNK ameliorates hypoxia-induced retinopathy through interference with VEGF expression

Gumá

Rius

Duong-Polk

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

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Many ocular pathologies, including retinopathy of prematurity (ROP), diabetic retinopathy, and age-related macular degeneration, result in vision loss because of aberrant neoangiogenesis. A common feature of these conditions is the presence of hypoxic areas and overexpression of the proangiogenic vascular endothelial growth factor (VEGF). The prevailing current treatment, laser ablation of the retina, is destructive and only partially effective. Preventive and less destructive therapies are much more desirable. Here, we show that mice lacking c-Jun N-terminal kinase 1 (JNK1) exhibit reduced pathological angiogenesis and lower levels of retinal VEGF production in a murine model of ROP. We found that hypoxia induces JNK activation and regulates VEGF expression by enhancing the binding of phospho-c-Jun to the VEGF promoter. Intravitreal injection of a specific JNK inhibitor decreases retinal VEGF expression and reduces pathological retinal neovascularization without obvious side effects. These results strongly suggest that JNK1 plays a key role in retinal neoangiogenesis and that it represents a new pharmacological target for treatment of diseases where excessive neoangiogenesis is the underlying pathology.neoangiogenesis ͉ retinopathy of prematurity

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mentioning

confidence: 99%

Genetic and pharmacological inhibition of JNK ameliorates hypoxia-induced retinopathy through interference with VEGF expression

Gumá

Rius

Duong-Polk

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

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“…[24] In another study, 13 eyes were enrolled; retinal detachment developed in 4 eyes after intravitreal injection of bevacizumab and all of them were treated by deep vitrectomy. [10] VEGF is necessary for normal vascularization in growing infants, and anti-VEGF properties can be harmful for normal vascularization.…”

Section: Discussionmentioning

confidence: 99%

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Kasiri

2017

AJP

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Objective: Vascular endothelial growth factor (VEGF), originally known as vascular permeability factor with different important roles in triggering vasculogenesis and angiogenesis. This protein has a pivotal role in retinopathy of prematurity (ROP). This study aims to evaluate the efficacy of VEGF inhibitor with cryotherapy for zone II Stage 3 plus ROP. Methods: In a prospective controlled clinical trial was performed on 6 infants, 12 eyes with zone II Stage 3 plus ROP. There was neurological visual impairment (NVI) in one eye. Under general anesthesia after confirmation of staging, prep and drape done cryotherapy of avascular retina in two rows combined with intravitreal injection of 0.625 mg bevacizumab in 0.025 ml was performed, and in one eye with iris neovascularization 0.625 mg intracameral bevacizumab injected too, all eyes were examined in 3 days, 1 th , 4 th , and 12 th week after procedure. Results: Regression of NVI in 3 days and retinal neovascularization in 1 week period post operation. Conclusion: One session cryotherapy combined with intravitreal injection of 0.625 mg of bevacizumab can be effective in management of zone II Stage 3 plus ROP, more studies with more participants seems to be necessary.

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“…The role of vascular endothelial growth factor (VEGF) in the pathogenesis and progression of ROP has been well documented (1,2). The beneficial effects of intravitreal anti-VEGF agents in ROP management have been shown in previous studies (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In a randomized and controlled multicenter study of stage 3 ROP with plus disease, intravitreal bevacizumab therapy appeared to excel conventional laser therapy for Zone I disease, and had comparable results with laser therapy for Zone II disease (8).…”

Section: Introductionmentioning

confidence: 99%

Intravitreal bevacizumab for retinopathy of prematurity in infants ineligible for laser therapy*

et al. 2016

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Background/aim: To evaluate refractive and strabismic results and the efficacy of intravitreal bevacizumab in retinopathy of prematurity (ROP) ineligible for laser therapy. Materials and methods:Thirty-nine eyes of 20 consecutive infants with high-risk prethreshold ROP (11 infants with Zone I and 9 infants with Zone II disease) who were ineligible for laser therapy due to systemic and/or ocular conditions were treated with intravitreal bevacizumab. Recurrent retinopathy was treated with laser ablation. The final follow-up examination was performed at 29.8 ± 6.0 months of corrected age.Results: All eyes responded to the initial treatment with intravitreal bevacizumab. ROP recurred in 8 eyes (36%) with initial Zone I disease and in only 2 eyes (11%) with initial Zone II disease, which were successfully treated with laser ablation. No eye developed myopia higher than 5.0 diopters. At 2.5 years, the Zone I eyes that had received laser treatment appeared to be more myopic than the Zone I eyes treated only with intravitreal bevacizumab (P = 0.038). A tendency for a higher incidence of strabismus after additional laser therapy was also noted, but was not significant (P = 0.22). Conclusion:Avoidance or even deferral of laser ablation with intravitreal bevacizumab may lead to less myopization in ROP compared with conventional laser treatment.

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Efficacy of intravitreal injection of bevacizumab for severe retinopathy of prematurity: a pilot study

Abstract: There results suggest that intravitreal injection of bevacizumab seems to be associated with reduced neovascularisation without apparent ocular or systemic adverse effects, and is thus beneficial for treating severe ROP that is refractory to conventional laser therapy.

Cited by 147 publications

References 28 publications

Genetic and pharmacological inhibition of JNK ameliorates hypoxia-induced retinopathy through interference with VEGF expression

Genetic and pharmacological inhibition of JNK ameliorates hypoxia-induced retinopathy through interference with VEGF expression

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Intravitreal bevacizumab for retinopathy of prematurity in infants ineligible for laser therapy*

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