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The vascularization process after intravitreal ranibizumab injections for aggressive posterior retinopathy of
Emine Alyamaç Sukgen1, Yusuf Koçluk1
1Department of Ophthalmology, Adana Numune Training and Research Hospital, Adana, Turkey.
Insights
Intravitreal ranibizumab treatment for aggressive posterior retinopathy of prematurity (AP-ROP) in infants showed initial regression but delayed retinal vascularization. Further research is needed to understand vascularization timing after anti-VEGF therapy.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Vascular Biology
Background:
- Aggressive posterior retinopathy of prematurity (AP-ROP) is a severe condition affecting premature infants.
- Intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents are used to treat ROP.
- Understanding the impact of these treatments on retinal vascularization is crucial.
Purpose of the Study:
- To evaluate the retinal vascularization process in infants with AP-ROP after intravitreal ranibizumab administration.
- To assess the timing and completeness of retinal vascularization post-treatment.
Main Methods:
- Retrospective analysis of 26 eyes from 13 infants with AP-ROP treated with 0.25 mg intravitreal ranibizumab.
- Weekly follow-up evaluations until complete retinal vascularization.
- Analysis of vascularization patterns and time to completion.
Main Results:
- Complete regression of AP-ROP observed within 48-72 hours post-injection.
- Average complete vascularization: Zone II at 45 weeks (range 41-56), Zone III at 56 weeks (range 50-65).
- Reactivation occurred in 7 patients; 2 required additional treatment. Two patients had peripheral avascular areas at 1 year.
Conclusions:
- Intravitreal ranibizumab in AP-ROP infants leads to delayed retinal vascularization.
- Further studies are required to determine optimal timing and mechanisms of vascularization following intravitreal anti-VEGF therapy.
Purpose::
To evaluate the retinal vascularization process after intravitreal ranibizumab was administered to infants with aggressive posterior retinopathy of prematurity (AP-ROP).
Methods::
Twenty-six eyes of 13 infants with AP-ROP who received 0.25 mg intravitreal ranibizumab were retrospectively investigated. The patients were evaluated at weekly follow-up visits, and the findings were analyzed after retinal vascularization was complete.
Results::
The results showed regression in the AP-ROP of all the patients within the first 48-72 h. Average time for complete vascularization of the nasal quadrant (zone II) was postmenstrual week 45 (range 41-56), and vascularization of the temporal quadrant (zone III) was completed in the postmenstrual week 56 (range 50-65). Reactivation was observed in seven patients, on average at postmenstrual week 42; two of these patients underwent additional treatment. Two patients presented with avascular areas in the peripheral retina despite being 1 year old.
Conclusion::
These results showed that retinal vascularization following intravitreal ranibizumab was completed after a delay in patients with AP-ROP. Further studies are necessary to evaluate when and how vascularization occurs after intravitreal anti-vascular endothelial growth factor treatments.