Serious adverse events and visual outcomes of rescue therapy using adjunct bevacizumab to laser and surgery for retinopathy of prematurity. The Indian Twin Cities Retinopathy of Prematurity Screening database Report number 5

Jalali, Subhadra; Balakrishnan, Divya; Zeynalova, Zarifa; Padhi, Tapas Ranjan; Rani, Padmaja Kumari

doi:10.1136/archdischild-2012-302365

Cited by 65 publications

(41 citation statements)

References 24 publications

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“…13,14 There have also been numerous reports on associations of intravitreal anti-VEGF agents 8 with prolonged, persistent avascular retina, recurrent IVNV, and even blindness from retinal detachment. 16,76 Early studies reported that the risk of ROP following laser or cryotherapy generally was removed after about 45 weeks post-gestational age. 77 However, recurrences after anti-VEGF were reported at 60 weeks post-gestational age.…”

Section: Consideration Of Anti-vegf Agents In Severe Rop: Knowledge Fmentioning

confidence: 99%

Vascular Endothelial Growth Factor Antagonist Therapy for Retinopathy of Prematurity

Hartnett¹

2014

Clinics in Perinatology

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Synopsis In this article we discuss the growing problem of ROP worldwide, treatments for severe ROP including standard of care laser treatment, and the need for new treatments. We will also discuss the reasons to consider inhibiting the VEGF signaling pathway in severe ROP and the concerns about broad VEGF inhibition. Finally, we will cover the potential role of VEGF in ROP based on studies in animal models of oxygen-induced retinopathy (OIR), the effects of anti-VEGF based on basic research data, and the clinical relevance of these data.

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Section: Consideration Of Anti-vegf Agents In Severe Rop: Knowledge Fmentioning

confidence: 99%

Vascular Endothelial Growth Factor Antagonist Therapy for Retinopathy of Prematurity

Hartnett¹

2014

Clinics in Perinatology

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“…RP is a retinal degenerative disorder in which blood vessel degeneration contributes significantly to retinal atrophy, ultimately leading to loss of vision. In addition, recent studies have shown that prolonged treatment with antiangiogenic drugs may cause tissue degeneration (4)(5)(6). Given the increasing incidence of many degenerative diseases in an aging population and the rapidly growing clinical use of antiangiogenic drugs, there is an urgent need for strategies promoting blood vessel survival and protection.…”

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confidence: 99%

Vasoprotective effect of PDGF-CC mediated by HMOX1 rescues retinal degeneration

Zhao

Kumar

Lee

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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Significance PDGF-CC plays critical roles in many biological processes, such as development, tumor growth, and angiogenesis. However, its role in blood vessel survival/regression and the underlying mechanisms remain unknown. Here, using different loss- and gain-of-function assays and multiple model systems, we show that PDGF-CC is a critical vascular protective factor required to maintain blood vessel survival. Mechanistically, we found that heme oxygenase-1 (HMOX1) activity is crucial for the vascular protective/survival effect of PDGF-CC. Given the general involvement of vascular degeneration in most degenerative diseases, PDGF-CC may be of therapeutic use in treating different types of degenerative disorders. Our findings point out that the PDGF-CC level should be monitored closely in various pathological conditions to ensure normal blood vessel survival.

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“…Especially important are the reports of initial regression with delayed recurrent neovascularization after bevacizumab (with or without laser photocoagulation), which occurred up to 19 weeks after intravitreal injection [52–57]. Other serious side effects included acute contraction of proliferative membrane [44,58–59], vascular sheathing [57], choroidal ischemia [60], optic atrophy [61], disc pallor [62], retinal break, RPE rupture [61] and choroidal rupture [63], which all occurred after bevacizumab combined with laser photocoagulation. Less severe side effects were cataract [51,57], increased IOP [51,64] and mild vitreous organization [65].…”

Section: Resultsmentioning

confidence: 99%

“…In 25 trials no systemic complications were reported [43–44,47,49–50,57,59,62,64–68,74–85]. There was one report of short-term raised liver enzymes after bevacizumab injection [61] and one case report showing reduced vascular activity in the contralateral eye [5]. …”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis on the Safety of Vascular Endothelial Growth Factor (VEGF) Inhibitors for the Treatment of Retinopathy of Prematurity

et al. 2015

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IntroductionLaser photocoagulation is the current gold standard treatment for proliferative retinopathy of prematurity (ROP). However, it permanently reduces the visual field and might induce myopia. Vascular endothelial growth factor (VEGF) inhibitors for the treatment of ROP may enable continuing vascularization of the retina, potentially allowing the preservation of the visual field. However, for their use in infants concern remains. This meta-analysis explores the safety of VEGF inhibitors.MethodsThe Ovid Interface was used to perform a systematic review of the literature in the databases PubMed, EMBASE and the Cochrane Library.ResultsThis meta-analysis included 24 original reports (including 1.457 eyes) on VEGF inhibitor treatment for ROP. The trials were solely observational except for one randomized and two case-control studies. We estimated a 6-month risk of retreatment per eye of 2.8%, and a 6-month risk of ocular complication without the need of retreatment of 1.6% per eye. Systemic complications were only reported as isolated incidents.DiscussionVEGF inhibitors seem to be associated with low recurrence rates and ocular complication rates. They may have the benefit of potentially allowing the preservation of visual field and lower rates of myopia. Due to the lack of data, the risk of systemic side effects cannot be assessed.

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Serious adverse events and visual outcomes of rescue therapy using adjunct bevacizumab to laser and surgery for retinopathy of prematurity. The Indian Twin Cities Retinopathy of Prematurity Screening database Report number 5

Cited by 65 publications

References 24 publications

Vascular Endothelial Growth Factor Antagonist Therapy for Retinopathy of Prematurity

Vascular Endothelial Growth Factor Antagonist Therapy for Retinopathy of Prematurity

Vasoprotective effect of PDGF-CC mediated by HMOX1 rescues retinal degeneration

A Systematic Review and Meta-Analysis on the Safety of Vascular Endothelial Growth Factor (VEGF) Inhibitors for the Treatment of Retinopathy of Prematurity

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