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Does general anesthesia or intravitreal injection affect neurodevelopment in children undergoing ophthalmic
Lindsay M De Andrade1, Sherwin J Isenberg
1Stein Eye Institute, University of California, Los Angeles, California, USA.
Current Opinion in Ophthalmology
|July 18, 2019
Summary
Recent studies show that general anesthesia and anti-VEGF injections in children do not have long-term negative neurodevelopmental effects. Ocular procedures should proceed as needed for improved vision and quality of life.
Area of Science:
- Pediatric neurodevelopmental research
- Ophthalmology
- Anesthesiology
Background:
- Concerns exist regarding potential neurodevelopmental impacts of general anesthesia and intravitreal anti-VEGF injections in pediatric patients.
- Early animal and human studies suggested possible negative effects, prompting further investigation.
- Retinopathy of prematurity is a condition in neonates that may require intravitreal anti-VEGF injections.
Purpose of the Study:
- To review recent scientific literature on the neurodevelopmental outcomes associated with general anesthesia and intravitreal anti-VEGF injections in children.
- To synthesize findings from various study designs, including animal models, retrospective, sibling, and prospective human studies.
- To evaluate the long-term safety profile of these medical interventions in the pediatric population.
Main Methods:
- Systematic review of recent studies investigating neurodevelopmental outcomes.
- Analysis of data from animal models (rodents, primates) and human studies (retrospective, sibling, prospective).
- Comparison of outcomes between children receiving intravitreal injections and those undergoing laser treatment for retinopathy of prematurity.
Main Results:
- Initial animal studies indicated negative neurodevelopmental impacts from anesthetics.
- Human studies yielded mixed results, with early retrospective reviews showing varied outcomes.
- More recent prospective and sibling studies, as well as later reviews on anti-VEGF injections, found no clinically significant long-term neurodevelopmental impact.
Conclusions:
- Current evidence suggests that general anesthesia events and intravitreal anti-VEGF injections do not lead to long-term negative neurodevelopmental consequences in pediatric patients.
- Ocular procedures essential for improving a child's vision or quality of life should not be postponed due to these concerns.
- The findings support the continued use of necessary medical interventions in pediatric ophthalmology and surgery.
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