Long-Term Effects of Anti-Vegf Monotherapy for Retinopathy of Prematurity on the Retinal and Refractive Development of Eye

Abstract

Purpose: To evaluate vascular maturation of retina, axial, refractive, and foveal development after anti-VEGF treatment including bevacizumab, ranibizumab, and aflibercept in infants with treatment requiring retinopathy of prematurity (ROP) in long term.Methods: This retrospective chart review study included children with a history of any anti-VEGF monotherapy for ROP in Zone 1 or posterior Zone 2 who have reached at least 24 months of corrected age. The records of ophthalmologic examination including strabismus evaluation, visual acuity measurement, refractive and axial measurements, optical coherence tomography, and fundus fluorescein angiography examinations with RetCam III were reviewed.Results: A total of 36 eyes of 18 children met the inclusion criteria. The mean gestational age at birth was 27.8 6 2.13 (23-30) weeks, and ocular assessments were performed between 33 and 61.5 (mean: 42.58 6 8.6) months of corrected age. Treatment was with bevacizumab in 10 eyes, with ranibizumab in 14 eyes, and with aflibercept in 12 eyes. The mean spherical equivalent was 20.25 6 1.82; axial length was 20.816 0.62 mm. There was no significant difference among three anti-VEGF groups regarding the abnormal vascular retinal development (P = 0.183) or leakage (P = 0.842) on fluorescein angiography.Conclusion: All the anti-VEGF agents provided similar adequate axial and refractive development as well as similar abnormal vascular development in the peripheral retina. The long-term impact of this abnormally vascularized peripheral retina is a curiosity issue. From this point of view, it is an important need to determine the follow-up period and method after the anti-VEGF treatment for ROP.