Fluorescein Angiographic Findings of Peripheral Retinal Vasculature after Intravitreal Conbercept versus Ranibizumab for Retinopathy of Prematurity

Abstract

Purpose. To evaluate angiographic findings of peripheral retina vasculature in retinopathy of prematurity (ROP) neonates who received intravitreal conbercept (IVC) or ranibizumab (IVR). Methods. Fluorescein angiography (FA) findings were retrospectively evaluated for ROP neonates who received IVC or IVR. Outcome measures included peripheral avascular zone, vascular leakage, vascular blunting, vascular loops, vascular dilatation, arteriovenous shunt, and capillary dropout. Results. Fifty-four eyes (28 patients) with ROP were included. Twenty-nine eyes (15 patients) received IVC, and 25 eyes (13 patients) received IVR. For infants of the IVC group, the mean gestational age, birth weight, and postmenstrual age (PMA) at the initial treatment were 28.96 ± 2.36 weeks, 1168.8 ± 344.5 g, and 41.22 ± 4.39 weeks, respectively. For the IVR group, they were 28.83 ± 2.34 weeks, 1255.0 ± 356.9 g, and 39.42 ± 2.77 weeks, respectively (P=0.817, 0.522, and 0.075). For the IVC group, FA performed at 71.29–115.43 weeks PMA showed 96.55% of eyes had avascular zone; vascular leakage was found in 24.14% eyes; vascular blunting, vascular dilation, vascular loops, arteriovenous shunt, and capillary dropout were found in 96.55%, 72.41%, 79.31%, 48.28%, and 68.97% eyes, respectively. For the IVR group, FA performed at 65.57–133.71 weeks PMA showed 92.0% of eyes had avascular zone; vascular leakage was found in 40.0% eyes; vascular blunting, dilatation, loops, arteriovenous shunt, and capillary dropout were found in 100%, 60.0%, 64.0%, 36.0%, and 68.0% eyes, respectively. Conclusion. No significant difference can be observed between the IVC group and IVR group for peripheral vascular structure anomalies with FA evidence. FA studies should be considered to assess the status of the peripheral retinal vasculature to determine therapeutic outcomes and potential functional outcomes.

Different Types of Hyperfluorescence Observed in Post Anti-VEGF Fluorescein Angiographic Patterns in Retinopathy of Prematurity Patients

“…In our series, the hyperfluorescence only existed in almost one-fifth eyes requiring anti-VEGF treatment, which is much fewer than previous studies ( 10 , 13 , 14 ). In a recent study evaluating the FA findings of eyes primarily treated with ranibizumab, persistent vascular leakage has been evident in FA in 40% of eyes.…”

“…Since the scale of our study is much bigger and more infants only require anti-VEGF treatment were enrolled, fewer hyperfluorescence could be defined. On the other hand, the average PNA of FA examinations was 18.12 ± 9.29 months after birth for our study, which was also a bit later than the previous FA studies ( 10 , 14 ).…”

“…In a recent study evaluating the FA findings of eyes primarily treated with ranibizumab, persistent vascular leakage has been evident in FA in 40% of eyes. And, in this study, 93.75% eyes received bilateral laser ablation treatment ( 14 ). In Lepore et al's study, different kinds of hyperfluorescent lesions were defined in eyes undergoing laser treatment, which also showed much more higher hyperfluorescence in FA ( 13 ).…”

“…Fluorescein angiography (FA), as an imaging modality, which illustrates the vascular structure and provides more useful information for the observation of peripheral retinal vascular, can be an important adjunct to indirect ophthalmoscopy ( 8 – 10 ). In the past decade, peripheral vascular abnormalities, including incomplete vascularization, hyperfluorescent lesions, vascular leakage, vascular dilation, vascular blunting, and capillary dropout, have been reported in ROP ( 10 – 14 ).…”

New trends in intravitreal anti-VEGF therapy for ROP

“…In another retrospective study 60 comparison between same two drugs focus on vascular fluorangiographic parameters of the retinal periphery: on 29 eyes treated with Conbercept and 25 eyes with Ranibizumab, did not describe significant percentage differences in vascular anomalies between the two groups, suggesting similar retinal effects.…”