Parag K Shah1, Prema Subramanian1, Narendran Venkatapathy1, Robison Vernon Paul Chan2, Michael F Chiang3, John Peter Campbell4. 1. Pediatric Retina & Ocular Oncology Division, Aravind Eye Hospital, Coimbatore, India. 2. Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago. 3. Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon; Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon. 4. Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon. Electronic address: campbelp@ohsu.edu.
Abstract
BACKGROUND: Aggressive posterior retinopathy of prematurity (APROP), which has a poor visual prognosis, is common in low- and middle-income countries (LMICs) as a result of suboptimal oxygen monitoring (primary prevention). The purpose of this study was to compare outcomes in APROP eyes treated with laser to eyes treated with antivascular endothelial growth factor (anti-VEGF) therapy. METHODS: The medical records of a cohort of APROP eyes treated with anti-VEGF (2010-2018) and another of eyes treated with laser photocoagulation (2002-2010) at the same institution in South India were reviewed retrospectively and compared. The main outcome was the proportion of eyes developing retinal detachment during resolution of acute ROP. RESULTS: A total of 398 eyes of 199 preterm babies with APROP were included: 168 eyes were treated with photocoagulation; 230, with anti-VEGF. From 2002 to 2010, compared to the more recent cohort, babies diagnosed with APROP tended to be heavier (P < 0.001), older (P < 0.001), and exposed to fewer days of oxygen (P = 0.02). In the laser-treated cohort, 17 of 168 eyes (10%) developed retinal detachment (7, stage 5; 12, stage 4), compared with 3 of 230 (1%) in the anti-VEGF cohort (all stage 4 [P = 0.002]). CONCLUSIONS: The incidence of retinal detachment was significantly lower in eyes treated with anti-VEGF compared with laser-.treated eyes In the absence of a randomized trial, these data suggest that anti-VEGF may lead to better anatomic outcomes, although questions remain concerning dosage, timing, and risks.
BACKGROUND:Aggressive posterior retinopathy of prematurity (APROP), which has a poor visual prognosis, is common in low- and middle-income countries (LMICs) as a result of suboptimal oxygen monitoring (primary prevention). The purpose of this study was to compare outcomes in APROP eyes treated with laser to eyes treated with antivascular endothelial growth factor (anti-VEGF) therapy. METHODS: The medical records of a cohort of APROP eyes treated with anti-VEGF (2010-2018) and another of eyes treated with laser photocoagulation (2002-2010) at the same institution in South India were reviewed retrospectively and compared. The main outcome was the proportion of eyes developing retinal detachment during resolution of acute ROP. RESULTS: A total of 398 eyes of 199 preterm babies with APROP were included: 168 eyes were treated with photocoagulation; 230, with anti-VEGF. From 2002 to 2010, compared to the more recent cohort, babies diagnosed with APROP tended to be heavier (P < 0.001), older (P < 0.001), and exposed to fewer days of oxygen (P = 0.02). In the laser-treated cohort, 17 of 168 eyes (10%) developed retinal detachment (7, stage 5; 12, stage 4), compared with 3 of 230 (1%) in the anti-VEGF cohort (all stage 4 [P = 0.002]). CONCLUSIONS: The incidence of retinal detachment was significantly lower in eyes treated with anti-VEGF compared with laser-.treated eyes In the absence of a randomized trial, these data suggest that anti-VEGF may lead to better anatomic outcomes, although questions remain concerning dosage, timing, and risks.
Authors: Je Moon Yoon; Dong Hoon Shin; Sang Jin Kim; Don-Il Ham; Se Woong Kang; Yun Sil Chang; Won Soon Park Journal: Retina Date: 2017-01 Impact factor: 4.256
Authors: Rania M Bassiouny; Walid M Gaafar; Amgad El Nokrashy; Ameera G Abdelhameed; Eman A Attallah; Ahmed G Elgharieb; Mohamed R Bassiouny Journal: Eye (Lond) Date: 2021-10-28 Impact factor: 4.456
Authors: Kellyn N Bellsmith; James Brown; Sang Jin Kim; Isaac H Goldstein; Aaron Coyner; Susan Ostmo; Kishan Gupta; R V Paul Chan; Jayashree Kalpathy-Cramer; Michael F Chiang; J Peter Campbell Journal: Ophthalmology Date: 2020-02-07 Impact factor: 12.079
Authors: J Peter Campbell; Praveer Singh; Travis K Redd; James M Brown; Parag K Shah; Prema Subramanian; Renu Rajan; Nita Valikodath; Emily Cole; Susan Ostmo; R V Paul Chan; Narendran Venkatapathy; Michael F Chiang; Jayashree Kalpathy-Cramer Journal: Pediatrics Date: 2021-03 Impact factor: 7.124