Late-onset tractional fibrovascular proliferation post–intravitreal bevacizumab following treatment of retinopathy of prematurity

Agarwal-Sinha, Swati; Guevara, Jade Gieseke; Amin, Sarina

doi:10.1016/j.jcjo.2017.09.028

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…2,3 Late recurrence of ROP has been reported after IVB and is thought to be driven by hypoxic avascular peripheral retina. [4][5][6] The long-term risk of late recurrence is unknown. At our institution, persistent avascular retina is imaged with FA and treated with laser when vessels do not extend into zone 3 by 60 weeks post-menstrual age (PMA).…”

Section: Discussionmentioning

confidence: 99%

Fluorescein Angiography in Retinopathy of Prematurity: Comparison of Infants Treated with Bevacizumab to Those with Spontaneous Regression

Mansukhani

Hutchinson

Neustein

et al. 2019

Ophthalmology Retina

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Objective: Medium and long-term sequelae of intravitreal bevacizumab (IVB) for type 1 retinopathy of prematurity (ROP) are uncertain. Our aim was to describe the fluorescein angiography (FA) findings in patients who received IVB as a primary treatment for type 1 ROP and compare them to findings in patients with spontaneously regressed ROP. Design: Retrospective cohort Participants: Patients with a history of retinopathy of prematurity, who underwent fluorescein angiography between December 1 st , 2013 and July 31 st , 2018. Patients were divided into 2 groups based on whether they had received IVB or had spontaneously regressed. Methods: We reviewed the angiograms in the 2 groups for neovascularization (NV) and other abnormal vascular patterns both in the periphery and the posterior pole. Main Outcome Measures: FA findings including NV, peripheral and macular vascular abnormalities. Results: Forty eyes of 20 infants were included in the IVB group and 16 eyes of 8 infants in the untreated group. Median gestational age was similar in the 2 groups (24.5 & 24.7 weeks respectively; p = 0.44) as was the median birth weight (648.5 & 560.0 g respectively; p=0.26). Median post-menstrual age at the time of FA was 65.1 and 83.9 weeks respectively (p = 0.0002). Review of angiograms demonstrated NV in 30.0% and 37.5% in the IVB and untreated cohorts, respectively (p=0.75). Abnormal vascular patterns in the periphery were similar in both groups

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Section: Discussionmentioning

confidence: 99%

Fluorescein Angiography in Retinopathy of Prematurity: Comparison of Infants Treated with Bevacizumab to Those with Spontaneous Regression

Mansukhani

Hutchinson

Neustein

et al. 2019

Ophthalmology Retina

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“…Peripheral retinal examinations in clinic are limited in children due to cooperation. In one prior case report, a child developed reactivation of ROP and developed bilateral tractional retinal detachments at 3 years of age after receiving examinations in clinic every 6 months [15]. Thus, by performing frequent examinations under anesthesia, we aim to identify recurrences early to prevent stage 4 and 5 ROP from developing.…”

Section: Methodsmentioning

confidence: 99%

“…While there is no clearly defined standard of care for the frequency of examinations in infants previously treated with bevacizumab for ROP beyond 65 weeks PMA [22], we pursue this aggressive approach to ensure that recurrence of ROP is not missed with possibly visually devastating outcomes due to multiple reports of recurrence up to 3 years of age [15][16][17] receiving examinations in clinic every 6 months [15]. Thus, by performing frequent examinations under anesthesia, we aim to identify recurrences early to prevent stage 4 and 5 ROP from developing.…”

Section: Treatment and Monitoring For Rop Recurrencementioning

confidence: 99%

“…It avoids the permanent destruction of the retina associated with panretinal photocoagulation or cryotherapy. However, treatment with IVB has been demonstrated to have late recurrences of stage 4 and 5 ROP beyond until 3 years of age [15][16][17], thus requiring frequent retinal examinations. FA is a relatively safe procedure commonly used by the providers to identify and document recurrent ROP and is used to study the retinal vasculature after treatment with bevacizumab [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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Angiographic Review of Choroidal Involution in Eyes with Retinopathy of Prematurity Treated with Bevacizumab

Islam¹,

Andersen²,

Agarwal-Sinha³

2020

Ophthalmic Res

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Purpose: Retinopathy of prematurity (ROP) is considered a disease of the inner retina; however, there is increasing evidence that demonstrates choroidal vasculature loss in ROP, leading to degeneration of outer retinal function and visual deterioration. Central choroidal thinning is noted in children with history of ROP using optical coherence tomography (OCT) imaging. This study characterizes the presence and persistence of choroidal loss angiographically in eyes of infants treated with intravitreal bevacizumab (IVB) for stage 3 ROP. Methods: Retrospectively reviewed the fluorescein angiography (FA) images of 62 eyes of 31 infants treated with IVB monotherapy. The eyes with good quality early-, mid-, and late-phase imaging were included in this study. The presence of choroidal hypofluoresence involving the central and or peripheral retina were noted. In infants with multiple FAs, serial FAs were analyzed for persistence of choroidal hypofluorescence. Results: The mean age and birth weight of infants was 24.4 weeks PMA and 683 grams, respectively. All infants received IVB monotherapy. 24 of 62 angiography images of sufficient quality reviewed showed the presence of choroidal hypofluorescence involving central and peripheral lobular loss in the early phase and its persistence into mid and late phases. 12 eyes demonstrated persistent choroidal loss on sequential FA until three years chronological age. Conclusions: The study demonstrates the presence of choroidal vascular loss angiographically both central and peripheral fundus in infants with ROP. It highlights the critical role of choroidal involution in outer retinal function that could affect visual outcomes.

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Long-term retinal vasculature abnormalities following intravitreal bevacizumab for retinopathy of prematurity

Sternfeld

Rahmani

Rossen

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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Late-onset tractional fibrovascular proliferation post–intravitreal bevacizumab following treatment of retinopathy of prematurity

Cited by 6 publications

References 7 publications

Fluorescein Angiography in Retinopathy of Prematurity: Comparison of Infants Treated with Bevacizumab to Those with Spontaneous Regression

Fluorescein Angiography in Retinopathy of Prematurity: Comparison of Infants Treated with Bevacizumab to Those with Spontaneous Regression

Angiographic Review of Choroidal Involution in Eyes with Retinopathy of Prematurity Treated with Bevacizumab

Long-term retinal vasculature abnormalities following intravitreal bevacizumab for retinopathy of prematurity

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