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OCT macular changes in type 1 ROP following Ranibizumab injections
Rawan Hosny1, Jylan Gouda2, Tamer A Macky2
1Department of Ophthalmology, Kasr AlAiny Hospital, Cairo University, 86 Saraya Street, Al Manial, Cairo, 11956, Egypt. rawan.m.hosny@students.kasralainy.edu.eg.
Insights
Ranibizumab injections for type 1 retinopathy of prematurity (ROP) led to outer retinal layer thickening and differentiation. However, macular edema resolution was inadequate, indicating potential long-term visual impairment risks.
Area of Science:
- Ophthalmology
- Neonatal Care
- Retinal Imaging
Background:
- Type 1 retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Ranibizumab injections are increasingly used to treat ROP, but their long-term effects on retinal structure require further investigation.
- Optical coherence tomography (OCT) is crucial for assessing macular changes in ROP.
Purpose of the Study:
- To investigate macular changes using OCT one month after Ranibizumab injections in infants with type 1 ROP.
- To evaluate the impact of Ranibizumab on central foveal thickness (CFT), inner retinal layer (IRL), and outer retinal layer (ORL) thickness.
- To assess the resolution of macular edema (ME) and its correlation with clinical outcomes.
Main Methods:
- A prospective study included preterm infants with type 1 ROP receiving Ranibizumab injections.
- Handheld OCT imaging was performed at baseline, 1 week, and 1 month post-injection.
- Measurements included CFT, IRL, and ORL thickness, along with assessment for ME and retinal layer differentiation.
Main Results:
- Significant increase in ORL thickness and differentiation (IS/OS junction, ELM appearance) observed at 1 month post-injection (p < 0.001).
- Macular edema (ME) was present in 50% of eyes, associated with lower birth weight (p=0.0290).
- Inadequate ME resolution (50% complete resolution) and no significant decrease in CFT were noted at 1 month. Regression of plus disease correlated with lower CFT.
Conclusions:
- Ranibizumab treatment in type 1 ROP eyes promotes ORL thickening and differentiation.
- However, inadequate ME resolution suggests potential for persistent visual impairment.
- Further research is needed to optimize treatment strategies for ROP to ensure complete macular recovery.
Aim:
To investigate the OCT macular changes in type 1 ROP one month following Ranibizumab injections.
Methods:
Preterm infants with type 1 ROP indicated for Ranibizumab injections were included in this study. Handheld OCT imaging was performed at baseline, 1 week, and 1 month post injection. Central full thickness (CFT), inner retinal layer (IRL), and outer retinal layer (ORL) thickness measurements were taken from foveal center and parafoveal region.
Results:
24 eyes of 12 infants were included in this study. There were no significant changes in the mean CFT and IRL thickness at 1 month (p = 0.5 and 0.1 respectively). However, there was significant increase in the mean ORL thickness at 1 month (69.9 ± 16, 96.1 ± 25 at baseline and one month respectively, p < 0.001), with differentiation (appearance of IS/OS junction ± ELM) in 55.6% of eyes. Macular edema (ME) was observed in 12 eyes (50%) and was associated with smaller birth weight (p = 0.0290). There was no significant decrease in mean CFT in eyes with ME at 1 month (p = 0.13), with complete resolution in only 6 eyes (50%) during the study period. Regression of plus was associated with lower CFT (1 week and 1 month; p = 0.02 and 0.03, respectively).
Conclusion:
Ranibizumab treated eyes in type 1 show ORL thickening and differentiation but with inadequate resolution of ME.
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