Intravitreal aflibercept injection in Indian eyes with retinopathy of prematurity

Abstract

Purpose: To study the efficacy of intravitreal Aflibercept, an anti Vascular Endothelial Growth factor, (anti-VEGF) in Retinopathy of Prematurity (ROP). Methods: This was a retrospective, interventional consecutive case series of 46 Indian eyes which received intravitreal injection of Aflibercept for High risk Prethreshold ROP, Threshold ROP, and Aggressive-Posterior ROP (AP-ROP). Results: Aflibercept was effective in achieving the primary endpoint, namely regression of ROP following the injection in all 46 eyes (100%) at one week following the injection. 32.6% (15/46) of eyes achieved secondary endpoint namely complete vascularization, with no recurrence of ROP at varying time intervals: as early as 15 weeks to as late as 29 weeks after injection, at intervals ranging from 49 to 64 weeks PCA. Conclusion: Intravitreal Aflibercept was effective in inducing complete regression of all types of ROP in all the eyes in our series. In addition, 32.6% of cases did not need a secondary intervention, with no recurrence of ROP and complete vascularization of the retina. In 81.8% of Zone I ROP eyes, Aflibercept facilitated continuation of retinal vascular development following regression of ROP, resulting in less extensive laser during treatment of ROP recurrence. This is the largest series of Aflibercept in ROP, till date as per MEDLINE search.

Comparison of aflibercept and bevacizumab in the treatment of type 1 retinopathy of prematurity

“…Similar to our study, in a series of 46 eyes receiving intravitreal aflibercept monotherapy alone, regression of ROP was seen in 100% of eyes. Although 32.6% (15/46) of eyes reached complete vascularization, incomplete vascularization was persisted in 67.4% of the eyes [18].…”

“…Third, the dosing of aflibercept for intravitreal injection in neonates has not been thoroughly tested, and there is some debate about the most effective dose, which necessitates more investigations. Most of the previous studies consider half-dose aflibercept (1 mg/0.025 ml) as a standard dose for intravitreal injection in ROP [18,23]. Recently, Ekinci et al showed that 100% of eyes that had been treated with standard dosage were completely regressed and eyes with a lack of response were present only in the low-dose group (0.4 mg/0.01 ml), although the difference between the groups was not statistically significant.…”

Low-Dose Ranıbızumab Admınıstratıon in Retınopathy of Prematurıty

“…Thirty two of the patients were female. The mean gestational age of the patients included in the study was 26.6 (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) weeks, and the mean birth weight was 905 (450-1970) grams. The mean postnatal week of the rst intravitreal injection for treatment was 9.1 (4-19) weeks, and the mean follow-up time was 63 (24-250) weeks.…”

“…A second injection was applied to 46 eyes of 23 babies 4 weeks after the rst injection. Of these, 38 eyes of 19 infants recovered with re-injection, peripheral retinal vascularization was completed at an average of postnatal week 25.6 ± 4.75 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). eight eyes of 4 babies who were re-injected; rescue argon laser photocoagulation therapy was applied approximately 9.2 (7-11) weeks after the start of treatment.…”

Erratum: Intravitreal aflibercept injection in Indian eyes with retinopathy of prematurity

“…In the article titled “Intravitreal aflibercept injection in Indian eyes with retinopathy of prematurity” published in pages 884-8, issue 6, vol. 67 of Indian Journal of Ophthalmology,[1] the article title incorrectly published as “Intravitreal aflibercept injection in Indian eyes with retinopathy of prematurity” instead of “Intravitreal Aflibercept in Retinopathy of Prematurity: Report no: 1.”…”