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Published on: December 31, 2015
Preferred Treatment Patterns of Retinopathy of Prematurity: An International Survey
Amy T Wang1, Shuan Dai1,2
1Department of Ophthalmology, Queensland Children's Hospital, South Brisbane 4101, Australia.
Insights
Anti-vascular endothelial growth factor (VEGF) therapy is increasingly preferred for aggressive retinopathy of prematurity (ROP) and ROP in specific zones. Laser treatment remains the primary choice for other ROP types and repeat treatments.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Medical Research
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Treatment patterns for ROP vary globally, with evolving therapeutic options.
- Anti-vascular endothelial growth factor (anti-VEGF) agents have emerged as a key treatment modality.
Purpose of the Study:
- To assess current preferred treatment strategies for retinopathy of prematurity (ROP).
- To examine global trends in the utilization of anti-VEGF therapy for ROP.
- To compare first-line and repeat treatment approaches for ROP.
Main Methods:
- A retrospective international survey of 14 questions was distributed to pediatric ophthalmologists.
- Data collected included treatment patterns, anti-VEGF use across ROP stages, and treatment comparisons.
- Responses from 54 ophthalmologists across 11 countries were analyzed.
Main Results:
- Anti-VEGF was the preferred first-line treatment for aggressive ROP (64.1%), Type 1 ROP in zone 1 (71.7%), and posterior zone 2 (56.6%).
- Laser therapy was favored for Type 1 ROP in anterior zone 2 (73.6%) and zone 3 (79.2%).
- Laser was the preferred retreatment modality after anti-VEGF injections; bevacizumab (0.625 mg) was the most common anti-VEGF agent.
Conclusions:
- The use of anti-VEGF as a first-line therapy for ROP is on the rise.
- Anti-VEGF is the preferred initial treatment for aggressive ROP and ROP in zone 1 and posterior zone 2.
- Laser therapy remains the primary choice for ROP in anterior zone 2 and zone 3, and for repeat treatments.
Abstract:
This paper assesses the preferred treatment patterns for retinopathy of prematurity (ROP) and examine trends in anti-vascular endothelial growth factor (VEGF) use for ROP. Methods: A retrospective survey consisting of 14 questions was distributed to paediatric ophthalmology interest groups internationally. Main outcome measures included treatment patterns, proportion of anti-VEGF use in different stages of ROP; and comparison of first-line treatments as well as repeat anti-VEGF treatments. Results: Fifty-four ophthalmologists from 11 different countries responded to the survey. The number of respondents per question, except one, ranged between 50-54. Per annum, there was an average number of 394 infants screened by each respondent. Anti-VEGF was the preferred treatment method for aggressive (A)-ROP (64.1%), Type 1 ROP in zone 1 (71.7%), and Type 1 ROP in posterior zone 2 (56.6%). The majority used laser as the first-line treatment of Type 1 ROP in anterior zone 2 (73.6%) and Type 1 ROP in zone 3 (79.2%). Laser was the preferred treatment modality utilised in infants requiring repeat treatment following anti-VEGF injection. The preferred anti-VEGF agent was bevacizumab administered at a dose of 0.625 mg. Conclusions: Anti-VEGF as first-line therapy has been increasing. Anti-VEGF appears to be the first-line treatment of choice for A-ROP, Type 1 ROP in zone 1 and posterior zone 2 and laser for Type 1 ROP in anterior zone 2 and zone 3.
