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Characterizing the Treatment Courses of Ranibizumab and Panretinal Photocoagulation for Retinopathy of Prematurity
Victoria Vought1, Rita Vought1, Alexander B Crane1,2
1Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey.
Insights
Ranibizumab treatment for retinopathy of prematurity (ROP) in infants showed higher retreatment and reactivation rates compared to panretinal photo-coagulation (PRP). This highlights varied real-world ROP treatment approaches and results.
Area of Science:
- Ophthalmology
- Neonatal Medicine
- Pediatric Care
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Current treatment modalities for ROP include laser photocoagulation and anti-vascular endothelial growth factor (anti-VEGF) therapy.
Purpose of the Study:
- To characterize the treatment course and outcomes of infants with ROP treated with ranibizumab, panretinal photo-coagulation (PRP), or combined therapy.
- To compare the effectiveness and patterns of care for different ROP treatment strategies.
Main Methods:
- Retrospective chart review of electronic health records for infants treated for ROP between 2016 and 2024.
- Analysis of treatment sequences, including initial therapy, retreatment, and final outcomes.
- Comparison of outcomes between ranibizumab and PRP treatment groups.
Main Results:
- Ranibizumab was the initial therapy in 58.3% of eyes, while PRP was used in 41.7%.
- ROP reactivation occurred in 19.4% of eyes, all initially treated with ranibizumab.
- Final outcomes included resolution in 45.8% of eyes, persistent avascular retina requiring PRP in 30.6%, and lost to follow-up in 22.2%.
Conclusions:
- Ranibizumab initiation in ROP treatment was associated with a younger patient age.
- Higher retreatment and reactivation events were observed with ranibizumab compared to PRP.
- Real-world ROP treatment patterns and outcomes demonstrate significant variability.
Purpose:
This study characterizes the treatment course and outcomes of infants with retinopathy of prematurity (ROP) treated with ranibizumab, panretinal photo-coagulation (PRP), or combined therapy.
Methods:
This retrospective chart review analyzed electronic health record data of infants treated for ROP between 2016 and 2024 at a single academic center.
Results:
Thirty-seven infants (72 eyes) were analyzed (59.05% male, average 24.7 ± 1.4 weeks). At first treatment, most eyes were zone II, stage 3+ (59.7%). All eyes had plus disease except six treated for persistent avascular retina. PRP was administered as initial therapy for 30 (41.7%) eyes and ranibizumab for 42 (58.3%). Thirty-five eyes (48.6%) underwent only one treatment of either PRP (26 eyes; 36.1%) or ranibizumab (9 eyes; 12.5%). A second treatment consisting of ranibizumab was administered in 4 (13.3%) of 30 eyes treated with PRP and 21 (50%) of 42 eyes injected with ranibizumab. Eight eyes (11.1%) had three treatments: two ranibizumab injections followed by PRP. Four eyes (5.6%) had four treatments: three ranibizumab injections followed by PRP. ROP reactivation occurred in 14 (19.4%) eyes that all received ranibizumab injection initially (mean 50.6 ± 16.7 days after most recent injection). Final outcomes included PRP for persistent avascular retina in 22 (30.6%) eyes, unknown final outcomes due to lost follow-up for 16 (22.2%), documented resolution in 33 (45.8%), and scleral buckling for a peripheral retinal detachment (stage 4a) for one (1.4%).
Conclusions:
Ranibizumab was initiated at a younger age with higher retreatment and reactivation events compared to PRP, underscoring variability in real-world ROP treatment patterns and outcomes.
