Progression of retinal vascularization after intravitreal anti-vascular-endothelial growth factor therapy in retinopathy of prematurity

Mirghorbani, Masoud; Rashidinia, Ali; Yaseri, Mehdi; Zarei, Mohammad; Khojasteh, Hassan; Bazvand, Fatemeh; Modjtahedi, Bobeck S.

doi:10.1186/s40942-022-00364-6

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…ROP treated with anti-VEGF injections has a higher risk of recurrence when retinal vascularization beyond the avascular area is very slow or halted and the ischemic retinal area becomes very large over time [23][24][25] . A question arises: To what extent should retinal blood vessels form after anti-VEGF injection to reduce the risk of ROP recurrence?…”

Section: Resultsmentioning

confidence: 99%

Characteristics of retinal vascularization in reactivated retinopathy of prematurity and clinical outcome after reinjection of ranibizumab

Jang

2024

Preprint

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This study aimed to determine whether the state of retinal vascularization after anti-vascular endothelial growth factor (anti-VEGF) injection can help predict the risk of recurrence of retinopathy of prematurity (ROP) and whether repeated injection treatment will be effective in case of recurrence. We retrospectively reviewed 24 infants (43 eyes) who received ranibizumab monotherapy between January 2021 and December 2022. All eyes were classified as having non-reactivated ROP or reactivated ROP. The state of ROP at the time of treatment, the time required for resolution of plus disease, and the extent of vascularization at 4 and 8 weeks after treatment were analyzed. Extent of retinal vascularization was measured with serial RETCAM™ fundus images using disc-fovea distance (DF) unit. ROP reactivation occurred in six infants (25.0%) and ten eyes (23.3%) after ranibizumab treatment. The mean reactivation interval after the initial injection was 9.0 ± 3.3 weeks (range 4–16). In the reactivated ROP group, the time required for the resolution of plus disease after injection was longer compared to the control group (13.3 days vs 5.2 days), with a mean ROP regression time of 3.4 weeks. All eyes in the reactivated ROP showed retinal vascularization < 0.5 DF from the original site at 4 weeks after injection. In 90% of cases with reactivated ROP, the extent of vascularization at 8 weeks after injection was within 1 DF from the original ROP site, and all cases showed reactivation in the posterior Zone II area. After ranibizumab retreatment, only one reactivated case with vitreous traction progressed to focal retinal detachment, while all other cases regressed with peripheral vascular development. The continuation of delayed retinal blood vessel development after ≥ 8 weeks may indicate a high likelihood of ROP recurrence. In the absence of vitreous traction, ranibizumab reinjection is likely to be effective in treating ROP recurrence.

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Section: Resultsmentioning

confidence: 99%

Characteristics of retinal vascularization in reactivated retinopathy of prematurity and clinical outcome after reinjection of ranibizumab

Jang

2024

Preprint

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“…ROP treated with anti-VEGF injections has a higher risk of recurrence when retinal vascularization beyond the avascular area is very slow or halted and the ischemic retinal area becomes very large over time 23 – 25 . A question arises: To what extent should retinal blood vessels form after anti-VEGF injection to reduce the risk of ROP recurrence?…”

Section: Discussionmentioning

confidence: 99%

Characteristics of retinal vascularization in reactivated retinopathy of prematurity requiring treatment and clinical outcome after reinjection of ranibizumab

Jang

2024

Sci Rep

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This study aimed to determine whether the state of retinal vascularization after anti-vascular endothelial growth factor (anti-VEGF) injection can help predict the risk of reactivated retinopathy of prematurity (ROP) requiring treatment and whether repeated ranibizumab injection will be effective in such cases. We retrospectively reviewed 24 infants (43 eyes) who received ranibizumab monotherapy between January 2021 and December 2022. All eyes were classified as having non-retreated ROP or retreated ROP. The state of ROP at the time of treatment, the time required for resolution of plus disease, and the extent of vascularization at 4 and 8 weeks after treatment were analyzed. Extent of temporal retinal vascularization was measured with serial fundus images using disc-fovea distance (DF) unit and disc diameter (DD). Reactivated ROP requiring treatment occurred in six infants (25.0%) and ten eyes (23.3%) after ranibizumab treatment. The mean retreatment interval was 9.0 ± 3.3 weeks (range 4–16). In the retreated ROP group, the time required for the resolution of plus disease after primary injection was longer compared to the control group (13.3 days vs 5.2 days), with a mean ROP regression time of 3.4 weeks. All eyes in the retreated ROP showed retinal vascularization < 0.5 DF from the original site at 4 weeks after injection. In 90% of cases with retreated ROP, the extent of vascularization at 8 weeks after injection was within 1 DF from the original ROP site, and all cases showed reactivation in the posterior Zone II area. The extent of retinal neovascularization in the retreated group was an average of 0.7 DD (vs 1.7 DD) and 1.3 DD (vs 3.3 DD) at 4 and 8 weeks after injection, respectively. After ranibizumab retreatment, only one reactivated case with vitreous traction progressed to focal retinal detachment, while all other cases regressed with peripheral vascular development. The continuation of delayed retinal blood vessel development after ≥ 8 weeks may indicate a high likelihood of reactivated ROP requiring treatment. In the absence of vitreous traction, ranibizumab reinjection is likely to be effective in treating reactivated ROP requiring treatment.

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“…Retinopathy of prematurity (ROP) is a major cause of treatable visual loss in the pediatric population [ 1 , 2 ]. The main pathogenesis behind this disease is the exposure of the immature retina to relative hyperoxia, resulting in the reduction of growth factors [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Choroidal measurements in decision making for retinopathy of prematurity: a decision tree analysis

Bahar,

Salari,

Dastjanifarahani

et al. 2024

Int J Retin Vitr

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Background To compare the choroidal thickness and vascular profile of premature infants with ROP (retinopathy of prematurity) using a handheld SD-OCT device. Methods We performed horizontal SD-OCT scans through the fovea in 115 eyes of 66 premature infants. Premature infants included 2 groups [infants with ROP requiring treatment (as treatment group) vs. infants without ROP or with ROP not- requiring treatment (as no-treatment group)] Choroidal thicknesses (CT) were measured at 5 points, including the fovea, 250 µm, and 500 µm mm nasal and temporal to the fovea. The choroidal vascularity index (CVI) and choroidal stromal index (CSI) were also calculated. The classification and regression tree (CRT) algorithm was used to predict the need for treatment based on all OCT characteristics. Results Mean CT was higher in 500 µm nasal to the fovea compared to temporal CT (275.8 ± 64.8 and 257.1 ± 57.07, P value < 0.03). No statistically significant difference was found regarding CVI, corrected CVI, and temporal and nasal CT in the treatment group versus the no-treatment group. The foveal CT was significantly lower in ROP patients with the plus disease compared to not-plus ROP (P value = 0.03. ANOVA, Bonferroni posthoc test). CT was not significantly different between plus and pre-plus patients (P-value = 0.9, ANOVA, Bonferroni posthoc test). No significant relationship was found between the stage of ROP and choroidal thickness (P value > 0.05, GEE). The decision tree analysis showed that in infants with ROP, the most important predictor for the need for treatment is CSI. Conclusion This study delineated the possible effectiveness of choroidal measurements as an additive to decision-making for ROP. We also demonstrated that choroidal involution is associated with the presence of plus disease, not with the stage of ROP. We demonstrated that choroidal measurements are very sensitive but not specific tools for assessing the need for treatment in ROP patients.

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Progression of retinal vascularization after intravitreal anti-vascular-endothelial growth factor therapy in retinopathy of prematurity

Cited by 4 publications

References 14 publications

Characteristics of retinal vascularization in reactivated retinopathy of prematurity and clinical outcome after reinjection of ranibizumab

Characteristics of retinal vascularization in reactivated retinopathy of prematurity and clinical outcome after reinjection of ranibizumab

Characteristics of retinal vascularization in reactivated retinopathy of prematurity requiring treatment and clinical outcome after reinjection of ranibizumab

Choroidal measurements in decision making for retinopathy of prematurity: a decision tree analysis

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