Venkateshnaidu Laveti1,2, Divya Balakrishnan1,2, Padmaja Kumari Rani1,2, Ashik Mohamed3, Subhadra Jalali4,5,6. 1. Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, Hyderabad, India. 2. Jasti V Ramanamma Children's Eye Care Centre, Kallam Anji Reddy Campus, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad, Telangana, 500034, India. 3. Ophthalmic Biophysics Laboratory, L V Prasad Eye Institute, Hyderabad, India. 4. Srimati Kanuri Santhamma Centre for Vitreoretinal Diseases, Hyderabad, India. subhadra@lvpei.org. 5. Jasti V Ramanamma Children's Eye Care Centre, Kallam Anji Reddy Campus, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad, Telangana, 500034, India. subhadra@lvpei.org. 6. Newborn Eye Health Alliance (NEHA), Hyderabad, India. subhadra@lvpei.org.
Abstract
PURPOSE: To evaluate, in a combined treatment strategy for treatment-warranted retinopathy of prematurity (ROP), which of the two is a better treatment sequence, peripheral laser photocoagulation (LPC-IVB) first or intravitreal bevacizumab (IVB-LPC) first. METHODS: Twenty-two babies (44 eyes) with ROP were recruited from 1 July 2014 to 30 March 2016. All the right eyes received LPC on day one followed by IVB on day four (LPC-IVB group). In all left eyes, IVB was injected on day one followed by LPC on day four (IVB-LPC group). The primary outcome measure was the proportion of eyes that had complete ROP regression with no additional treatment within 2 weeks of the onset of therapy. Retinal photography and drawings were used at each visit to document disease course. RESULTS: In LPC-IVB group, 72.7% (16/22) eyes had complete ROP regression with no additional treatment within 2 weeks of the onset of therapy. In the IVB-LPC group, 95.5% (21/22 eyes) had complete regression within 2 weeks. Additional laser had complete regression in all eyes in each group. One baby (two eyes, one from each group) had late recurrence at 5 months. CONCLUSION: The combined therapy strategy was successful for ROP management. Administration of anti-vascular endothelial growth factor injection before the peripheral laser was better than the reverse strategy of laser first. Late recurrences and adverse events were low.
PURPOSE: To evaluate, in a combined treatment strategy for treatment-warranted retinopathy of prematurity (ROP), which of the two is a better treatment sequence, peripheral laser photocoagulation (LPC-IVB) first or intravitreal bevacizumab (IVB-LPC) first. METHODS: Twenty-two babies (44 eyes) with ROP were recruited from 1 July 2014 to 30 March 2016. All the right eyes received LPC on day one followed by IVB on day four (LPC-IVB group). In all left eyes, IVB was injected on day one followed by LPC on day four (IVB-LPC group). The primary outcome measure was the proportion of eyes that had complete ROP regression with no additional treatment within 2 weeks of the onset of therapy. Retinal photography and drawings were used at each visit to document disease course. RESULTS: In LPC-IVB group, 72.7% (16/22) eyes had complete ROP regression with no additional treatment within 2 weeks of the onset of therapy. In the IVB-LPC group, 95.5% (21/22 eyes) had complete regression within 2 weeks. Additional laser had complete regression in all eyes in each group. One baby (two eyes, one from each group) had late recurrence at 5 months. CONCLUSION: The combined therapy strategy was successful for ROP management. Administration of anti-vascular endothelial growth factor injection before the peripheral laser was better than the reverse strategy of laser first. Late recurrences and adverse events were low.
Entities:
Keywords:
Aggressive posterior retinopathy of prematurity (APROP); Bevacizumab; Combined therapy; Intravitreal injection; Laser photocoagulation; Recurrent ROP; Retinopathy of prematurity
Authors: Geeta A Lalwani; Audina M Berrocal; Timothy G Murray; Maria Buch; Scott Cardone; Ditte Hess; Rose A Johnson; Carmen A Puliafito Journal: Retina Date: 2008-03 Impact factor: 4.256