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Nonresponse and Recurrence of Retinopathy of Prematurity After Intravitreal Ranibizumab Treatment
Insights
Intravitreal ranibizumab (IVR) effectively treats retinopathy of prematurity (ROP) in premature infants. While generally successful, some cases require retreatment due to nonresponse or recurrence, achieving complete regression in all instances.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Pharmacology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Type 1 ROP requires timely and effective intervention to prevent severe visual outcomes.
Purpose of the Study:
- To assess the surgical outcomes of type 1 retinopathy of prematurity (ROP) following intravitreal ranibizumab (IVR) treatment.
- To evaluate the efficacy and safety of IVR as a therapeutic option for ROP.
Main Methods:
- A prospective case series design was employed.
- Premature infants diagnosed with treatment-requiring ROP between 2013 and 2015 received IVR injections.
- Outcomes were evaluated based on ROP resolution, need for retreatment, and final visual acuity.
Main Results:
- Complete ROP resolution was achieved in 73% of eyes after a single IVR injection.
- Retreatment was necessary in 27% of eyes due to IVR nonresponse (18%) or ROP recurrence (9%).
- All treated eyes ultimately showed regressed ROP with attached retinas; median visual acuity was 0.3 LogMAR.
Conclusions:
- Intravitreal ranibizumab (IVR) demonstrates effectiveness and good tolerability for treating ROP.
- A subset of patients (27%) may require additional treatment following initial IVR due to nonresponse or recurrence.
- IVR offers a viable therapeutic strategy for managing sight-threatening ROP in premature infants.
Background And Objective:
To evaluate the surgical outcome of type 1 retinopathy of prematurity (ROP) after intravitreal ranibizumab (IVR) (Lucentis; Genentech, South San Francisco, CA) treatment.
Patients And Methods:
This was a prospective case series. Premature infants with treatment-requiring ROP who received IVR injections from 2013 to 2015 were included.
Results:
Twenty-two eyes of 12 children were included in the study. Complete resolution of ROP after a single IVR was noted in 73% of eyes. Retreatment was needed in 27% of eyes due to nonresponse to IVR (18%) or recurrence of ROP (9%). After that, all treated eyes (100%) demonstrated regressed ROP with attached retina. The median visual acuity was 0.3 LogMAR (range: 0 LogMAR to 0.8 LogMAR) with a mean follow-up of 25.2 months ± 6.8 months.
Conclusions:
IVR is effective and well-tolerated for patients with treatment-requiring ROP. However, nonresponse to IVR or recurrence of ROP after IVR was noted in 27% of treated eyes and required additional treatment. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1095-1105.].
