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[Treated cases of retinopathy of prematurity in Germany : 5-year data from the Retina.net ROP registry]
Insights
Treatment for retinopathy of prematurity (ROP) has shifted towards anti-VEGF agents over five years. Late recurrences are more common with anti-VEGF therapy, requiring careful monitoring.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Clinical Research
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Limited data from individual centers necessitates collaborative registries like Retina.net for comprehensive analysis.
- The Retina.net ROP registry facilitates joint analysis of treatment patterns and outcomes.
Purpose of the Study:
- To report and analyze treatment patterns for retinopathy of prematurity (ROP) over a five-year period.
- To identify trends in the utilization of different treatment modalities for ROP.
- To evaluate the impact of treatment choices on disease recurrence and complications.
Main Methods:
- Analysis of data from 150 infants (292 eyes) treated for ROP between January 2011 and December 2015.
- Inclusion of infants from 12 participating centers within the Retina.net ROP registry.
- Comparison of treatment patterns, including anti-VEGF therapy and laser photocoagulation, and analysis of recurrence rates and complications.
Main Results:
- ROP 3+ in zone II was the most frequent indication for treatment.
- A significant shift in treatment patterns was observed, with anti-VEGF use increasing from 10% in 2011 to 56% in 2014 and 30% in 2015.
- Anti-VEGF treatment was favored for aggressive ROP (AP-ROP, zone I), while laser photocoagulation was common for zone II disease. Late recurrences were more frequent with anti-VEGF therapy.
Conclusions:
- The study highlights an increasing trend in the use of anti-VEGF agents for ROP treatment in Germany.
- A selection bias exists, with anti-VEGF agents used for more aggressive ROP, influencing recurrence rate interpretations.
- The increased risk of late recurrences following anti-VEGF treatment is a critical clinical consideration.
Background:
Retinopathy of prematurity (ROP) is one of the main reasons for childhood blindness. The number of infants requiring treatment, however, is low for individual centers. The Retina.net ROP registry has been founded to allow a joint analysis of treatment patterns and courses post treatment.
Objective:
This paper reports treatment patterns over 5 years.
Material And Methods:
All infants born between January 2011 and December 2015 who were entered into the treatment registry by one of the 12 participating centers were analyzed.
Results:
The data of 150 infants (292 eyes) were analyzed and ROP 3+ in zone II was the most prevalent treatment indication. Gestational age and birth weight remained stable over the years. The treatment patterns, however, changed with anti-VEGF treatment (bevacizumab or ranibizumab) accounting for only 10% of treated eyes in 2011 but for 56% and 30% in 2014 and 2015, respectively. Almost all eyes with AP-ROP or zone I disease received anti-VEGF treatment. Zone II disease was predominantly treated with laser photocoagulation. Recurrences were more common and appeared later in the anti-VEGF group compared to the laser group (23%/interval 60 days vs. 17%/interval 23 days). Perioperative complications were evenly distributed across treatment groups.
Conclusion:
The data in this analysis represent about 10-15% of treated infants in Germany. The results provide evidence for an increasing use of anti-VEGF agents for ROP. The data reflect a selection bias for anti-VEGF treatment in eyes with a more aggressive disease. This needs to be considered when interpreting data such as disease recurrence rates. The risk for late recurrences after anti-VEGF treatment is of particular clinical significance.
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