Subretinal injection of ranibizumab in advanced pediatric vasoproliferative disorders with total retinal detachments

Peng, Jie; Liang, Tingyi; Chen, Chunli; Zhang, Qi; Xu, Yu; Liu, Jingjing; Zhao, Peiquan

doi:10.1007/s00417-020-04600-3

Cited by 5 publications

(10 citation statements)

References 20 publications

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“…IVR 1 week before operation can inhibit the neovascularization and avoid the formation of retinal fibrovascular proliferation (one of complications of IVR), allowing the surgeon to perform the procedure in a relatively inactive or "quiet" eye. IVR is performed for patients with neovascularization at Stage 2–4, while subretinal injection of anti-VEGF could be performed for active retinal hemorrhage at Stage 5 [ 14 , 15 ]. Laser coagulation and transscleral cryotherapy were also performed if appropriate.…”

Section: Methodsmentioning

confidence: 99%

Long-term clinical prognosis of 335 infant single-gene positive FEVR cases

et al. 2022

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Purpose To describe and analyze the clinical prognosis of infants diagnosed of familial exudative vitreoretinopathy (FEVR) with single gene mutation in long-term follow-up. Methods A retrospective case study was conducted on 355 FEVR infants with single positive gene. Result Of the 335 single-gene positive infant FEVR cases (under 3 years old), 20% (n = 67) was diagnosed of strabismus at first visit. Staging of various genotypes was different (P < 0.001). Patients with NDP mutations presented the most severe clinical phenotypes and patients with ZNF408 mutations presented the mildest clinical phenotypes. Most infants underwent surgery under 1 year old (5th stage 75 of 108 [69.44%]). The axial length of different genotypes showed no significant difference (P = 0.2891). The 1st to 3rd stage cases were given intravitreal injection and/or retina photocoagulation with the last follow-up vision above 20/67. The 4th to 5th stage cases received the transcorneal vitrectomy with lensectomy or lens sparing vitrectomy (LSV), whose lens maintained transparent after LSV (11/14[78.58%]). After 2 to 10 years of follow-up, 37.96% (41/108) of post-surgery cases showed retinal funnel-like unfold and posterior pole unfold, 69.57% (16/ 23) of which received second surgery for closure of pupil with good prognosis. At the last follow-up, 20% (60/300) were with vision above 20/200. Conclusion LRP5 gene mutation was the most common mutation in FEVR patients. The severity of the clinical phenotype varied with different gene mutations. The main surgical methods for cases at Stage 4–5 were transcorneal vitrectomy with lensectomy or LSV. The earlier FEVR occurred, the worse prognosis would be. Active surgical intervention and lens sparing were necessary for cases at Stage 4–5.

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Section: Methodsmentioning

confidence: 99%

Long-term clinical prognosis of 335 infant single-gene positive FEVR cases

et al. 2022

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“…Usually, eyes with TRDs in ROP tend to be vascularly inactive and in a cicatricial and fibrotic phase. However, adjunct use of anti-VEGF may be effective in select eyes with ongoing high vascular activity, which may cause intraoperative and postoperative bleeding 8,9. Anti-VEGF treatment before surgery reduces vascular activity and may allow earlier surgery.…”

Section: Ropmentioning

confidence: 99%

“…Vascularly active eyes that cannot be observed until the optimal timing for surgery may most likely benefit. Intravitreal injection for stage 4 and subretinal injection for stage 5 ROP have been reported 8,9. However, anti-VEGF treatment not only allows regression of neovascularization but also increases the fibrotic contraction with progressive TRD known as the “crunch phenomenon.”45–48 Therefore, surgery should be performed shortly (within a few days) after anti-VEGF injections before the progression of the TRD 49…”

Section: Ropmentioning

confidence: 99%

“…Vitreoretinal surgery for pediatric vitreoretinal diseases, such as retinopathy of prematurity (ROP), familial exudative vitreoretinopathy, and persistent fetal vasculature have evolved over the past several decades. Advances include a wide variety of small-gauge instruments,1–4 evidence-based approaches such as lens-sparing vitrectomy (LSV) for stage 4 ROP,5–7 and anti-vascular endothelial growth factor (VEGF) injections as a surgical adjunct 8,9. The main goal of pediatric retinal detachment surgery is to relieve tractional forces through scleral buckling (SB) and/or vitrectomy to reattachment the retina.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Complications in Retinopathy of Prematurity: Literature Review and Management Strategies

Wakabayashi

Yonekawa

2022

International Ophthalmology Clinics

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“…Peng et al described a novel technique of subretinal ranibizumab injection in eyes of children with advanced vasoproliferative disorders and total retinal detachment. Subretinal ranibizumab was effective in diminishing vascular activity in these patients [ 25 ]. Further, a subretinal approach was reported for the elimination of hard exudates in diabetic patients using a 38G needle [ 26 ] and aspiration of retained subretinal perfluorocarbon liquid has been achieved using 25G to 50G cannulas [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Subretinal Injection Techniques for Retinal Disease: A Review

Irigoyen

Alonso

Sanchez-Molina

et al. 2022

JCM

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Inherited retinal dystrophies (IRDs) affect an estimated 1 in every 2000 people, this corresponding to nearly 2 million cases worldwide. Currently, 270 genes have been associated with IRDs, most of them altering the function of photoreceptors and retinal pigment epithelium. Gene therapy has been proposed as a potential tool for improving visual function in these patients. Clinical trials in animal models and humans have been successful in various types of IRDs. Recently, voretigene neparvovec (Luxturna®) has been approved by the US Food and Drug Administration for the treatment of biallelic mutations in the RPE65 gene. The current state of the art in gene therapy involves the delivery of various types of viral vectors into the subretinal space to effectively transduce diseased photoreceptors and retinal pigment epithelium. For this, subretinal injection is becoming increasingly popular among researchers and clinicians. To date, several approaches for subretinal injection have been described in the scientific literature, all of them effective in accessing the subretinal space. The growth and development of gene therapy give rise to the need for a standardized procedure for subretinal injection that ensures the efficacy and safety of this new approach to drug delivery. The goal of this review is to offer an insight into the current subretinal injection techniques and understand the key factors in the success of this procedure.

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Subretinal injection of ranibizumab in advanced pediatric vasoproliferative disorders with total retinal detachments

Cited by 5 publications

References 20 publications

Long-term clinical prognosis of 335 infant single-gene positive FEVR cases

Long-term clinical prognosis of 335 infant single-gene positive FEVR cases

Surgical Complications in Retinopathy of Prematurity: Literature Review and Management Strategies

Subretinal Injection Techniques for Retinal Disease: A Review

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