Regression Rates Following the Treatment of Aggressive Posterior Retinopathy of Prematurity with Bevacizumab Versus Laser: 8-Year Retrospective Analysis
Simona D. Nicoară, Anne C. Ștefănuţ, Constanta Nascutzy, Gabriela C. Zaharie, Laura E. Toader, Tudor C. Drugan
Department of Ophthalmology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
Med Sci Monit 2016; 22:1192-1209
Retinopathy is a serious complication related to prematurity and a leading cause of childhood blindness. The aggressive posterior form of retinopathy of prematurity (APROP) has a worse anatomical and functional outcome following laser therapy, as compared with the classic form of the disease. The main outcome measures are the APROP regression rate, structural outcomes, and complications associated with intravitreal bevacizumab (IVB) versus laser photocoagulation in APROP.
MATERIAL AND METHODS: This is a retrospective case series that includes infants with APROP who received either IVB or laser photocoagulation and had a follow-up of at least 60 weeks (for the laser photocoagulation group) and 80 weeks (for the IVB group). In the first group, laser photocoagulation of the retina was carried out and in the second group, 1 bevacizumab injection was administered intravitreally. The following parameters were analyzed in each group: sex, gestational age, birth weight, postnatal age and postmenstrual age at treatment, APROP regression, sequelae, and complications. Statistical analysis was performed using Microsoft Excel and IBM SPSS (version 23.0).
RESULTS: The laser photocoagulation group consisted of 6 premature infants (12 eyes) and the IVB group consisted of 17 premature infants (34 eyes). Within the laser photocoagulation group, the evolution was favorable in 9 eyes (75%) and unfavorable in 3 eyes (25%). Within the IVB group, APROP regressed in 29 eyes (85.29%) and failed to regress in 5 eyes (14.71%). These differences are statistically significant, as proved by the McNemar test (P<0.001).
CONCLUSIONS: The IVB group had a statistically significant better outcome compared with the laser photocoagulation group, in APROP in our series.
Keywords: Angiogenesis Inhibitors - therapeutic use, Bevacizumab - therapeutic use, Birth Weight, Gestational Age, Infant, Newborn, Infant, Premature, Intravitreal Injections, Laser Coagulation, Laser Therapy - methods, Retinopathy of Prematurity - therapy