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Subretinal injection of ranibizumab in advanced pediatric vasoproliferative disorders with total retinal detachments
Jie Peng1, Tingyi Liang1, Chunli Chen2,3
1Department of ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Subretinal injection of ranibizumab (SRR) shows promise for treating pediatric total retinal detachments in vasoproliferative disorders. This novel technique effectively reduced vascular activity, though further trials are needed to confirm safety and efficacy.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pediatric Surgery
Background:
- Vascularly active total retinal detachments in children pose significant challenges.
- Current treatments may have limitations for advanced pediatric vasoproliferative disorders.
Purpose of the Study:
- To evaluate the surgical procedures, outcomes, and complications of a novel subretinal injection of ranibizumab (SRR) technique.
- To assess the efficacy of SRR as a primary treatment for pediatric total retinal detachments.
Main Methods:
- Retrospective study of 37 eyes from 26 children treated with SRR between 2012 and 2018.
- SRR involved subretinal injection of ranibizumab (0.25 mg/0.025 ml).
- Data collected included demographics, ocular examination, anatomic outcomes, and complications.
Main Results:
- All 37 eyes showed decreased vascular activity at 1-week post-procedure.
- At 1 month, vascular activity decreased in 68.6% and resolved in 31.4% of eyes.
- Minor complications included subconjunctival hemorrhage (5.4%) and wound leakage (2.7%).
Conclusions:
- Subretinal injection of ranibizumab (SRR) appears effective and promising for pediatric vasoproliferative disorders with total retinal detachments.
- The technique demonstrated a reduction in vascular activity and manageable complications.
- Larger, controlled trials are necessary to validate the safety and efficacy of SRR.
Purpose:
To describe the surgical procedures, outcomes, and complications of a novel technique of subretinal injection of ranibizumab (SRR).
Methods:
Between September 2012 and September 2018, 37 eyes of 26 consecutive children with vascularly active total retinal detachments in 1 or both eyes treated with SRR as primary treatment were included in this retrospective study. All included eyes received subretinal injection of ranibizumab (0.25 mg/ 0.025 ml). Data included demographics, ocular examination, and anatomic outcomes, following treatment and complications of eyes after SRR were collected.
Results:
Eleven patients had bilateral SRR injections and 15 had monocular SRR injection. Thirteen patients were diagnosed as retinopathy of prematurity. Of all patients, the mean gestational age was 34.5 ± 5.1 weeks (range: 29.6~40.7 weeks), and birth weight was 2328.1 ± 1083.9 g (range: 940~3900 g). On 1-week postoperative follow-up, vascular activity decreased in all 37 eyes (100%). On the 1-month postoperative follow-up, vascular activity decreased but remained in 24 eyes (24/35, 68.6%) of 16 patients and vanished in 11 eyes (11/35, 31.4%) of 9 patients. No eye needed a secondary anti-VEGF therapy. Local subconjunctival hemorrhage was noted in two eyes (2/37, 5.4%). Localized wound leakage of subretinal fluid was also noted in one eye (1/37, 2.7%).
Conclusions:
In this very limited study, we showed that SRR in vascularly active advanced pediatric vasoproliferative disorders with total retinal detachments is effective and promising, although more extensive controlled trials will be needed to confirm its safety and efficacy.
