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Characteristics of Eyes Developing Retinal Detachment After Anti-vascular Endothelial Growth Factor Therapy for
Chiori Kondo1, Chiharu Iwahashi1, Shoko Utamura1
1Department of Ophthalmology, Kindai University Faculty of Medicine, Osakasayama, Japan.
Insights
Retinal detachment (RD) occurred in about 8% of eyes treated with anti-vascular endothelial growth factor (VEGF) for retinopathy of prematurity (ROP). Close monitoring is crucial for eyes with plus disease post-treatment.
Area of Science:
- Ophthalmology
- Neonatology
- Regenerative Medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of blindness in premature infants.
- Anti-vascular endothelial growth factor (anti-VEGF) therapy has become a standard treatment for severe ROP.
- The incidence and characteristics of retinal detachment (RD) following anti-VEGF treatment for ROP require further investigation.
Purpose of the Study:
- To determine the incidence of retinal detachment (RD) after anti-VEGF therapy for retinopathy of prematurity (ROP).
- To describe the clinical characteristics and outcomes of eyes that develop RD post-anti-VEGF treatment.
- To identify risk factors associated with RD development after anti-VEGF therapy for ROP.
Main Methods:
- A retrospective chart review was conducted on 76 eyes of 45 patients with stage 3 ROP treated with anti-VEGF therapy.
- Patients were divided into vitrectomy (V) and non-vitrectomy (non-V) groups based on the need for surgery due to RD.
- Data collected included patient demographics, clinical characteristics, treatment details, and follow-up outcomes.
Main Results:
- Approximately 8% of eyes developed RD approximately 10 weeks after anti-VEGF therapy.
- The vitrectomy group (n=6) had a higher proportion of eyes with plus disease (50%) compared to the non-vitrectomy group (10%).
- Circumferential RD was observed in four eyes, a type unique to post-anti-VEGF treatment.
Conclusions:
- Retinal detachment is a potential complication of anti-VEGF therapy for ROP, occurring in approximately 8% of treated eyes.
- Eyes with a history of plus disease require vigilant monitoring for RD after anti-VEGF treatment.
- Early detection and appropriate management, including vitrectomy for RD, are crucial for achieving retinal attachment.
Background:
We investigated the incidence and clinical characteristics of eyes showing retinal detachment (RD) after anti-vascular endothelial growth factor (VEGF) for retinopathy of prematurity (ROP).
Methods:
A retrospective chart review of 76 consecutive eyes of 45 patients (18 girls and 27 boys) with stage 3 ROP who received anti-VEGF therapy between January 2012 and August 2020 with a minimum follow-up of 6 months was conducted. Eyes were divided into two groups: the vitrectomy (V) group that required vitrectomy for RD after anti-VEGF therapy and the non-vitrectomy (non-V) group that did not require vitrectomy. Data were collected from patient charts, including sex, postmenstrual age (PMA) at birth, birth weight, PMA at anti-VEGF therapy, comorbidities, reactivation, examination interval, and subsequent vitrectomies.
Results:
The median PMA at birth was 24.7 (range, 22.1-29.3) weeks. Twenty-seven eyes (35.1%) exhibited ROP reactivation at 6.4 ± 3.1 weeks after anti-VEGF therapy. The V group included six eyes of five patients, all of whom exhibited reactivation and developed RD 10.1 ± 6.5 weeks after anti-VEGF therapy. The types of RD were conventional (classic) in two eyes and circumferential (unique to RD after anti-VEGF) in four eyes. Three eyes required repeated vitrectomy. All eyes, except one eye in the V group, achieved retinal attachment at the last examination. The non-V group included 70 eyes of 40 patients, of which 21 exhibited reactivation and were treated successfully with laser (17 eyes) or second anti-VEGF (4 eyes). The proportion of eyes with plus disease was significantly higher in the V group (50.0%) than in the non-V group (10.0%) (P = 0.035). V group included 3 of 22 eyes (13.6%) in which the interval between the last examination and the diagnosis of reactivation was <1 week and 3 of 5 eyes (60.0%) in which the interval was more than 1 week (P = 0.024). The two groups showed no significant differences in the other factors.
Conclusion:
Approximately 8% of eyes developed RD about 10 weeks after anti-VEGF therapy for ROP. Eyes with history of plus disease should be carefully monitored at appropriate intervals after anti-VEGF therapy for ROP.
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