EVALUATING EFFECTIVENESS OF LASER PHOTOCOAGULATION AND INTRAVITREAL ANTI-VEGF INJECTIONS IN STAGE III RETINOPATHY OF PREMATURITY

Main Article Content

Stuti Vikas Juneja Diti Patel Afsa Rathod

Abstract

Purpose: To compare the effectiveness of anti VEGF and laser photocoagulation treatment in stage III retinopathy of prematurity in infants at tertiary care hospital in central Gujarat.


Methods: This was a comparative prospective and retrospective observational study. 60 infants were diagnosed with stage III retinopathy of prematurity from which 20 infants were treated with laser and 40 infants treated with anti VEGF injection of 0.25 mg/0.025 mL Ranibizumab. Efficacy of both the treatments were compared in terms of regression of disease clinically. All Demographic and medical data was analyzed using MS excel for finding frequency, percentages and associations applying Chi-squared test and by Epi info™ (version-7.2.5).


Result: In this study 32(80%) infants who received anti VEGF and 8(40%) infants who received laser treatment showed stopped progression of neovascularization in single dose. Only 8(20%) infants needed re-treatment anti VEGF injection while 11(55%) infants required re-treatment laser therapy. So there was a statistically significant higher recurrence rate among infants who underwent laser therapy as compared to infants who underwent anti VEGF therapy (P=0.006).1(5%) infant lost both his eyes even after being treated with 2 sittings of laser treatment and who was <800g and very pre term birth so even with effort to treat, there was no regression and infant developed retinal detachment in both eyes.


Conclusion: Both the treatments are effective for treating ROP stage III infants but higher recurrence rate was found among infants who underwent laser therapy as compared to anti VEGF therapy.

Keywords

Anti vascular endothelial growth factor, laser treatment, Retrolental fibroplasia

Article Details

How to Cite
JUNEJA, Stuti Vikas; PATEL, Diti; RATHOD, Afsa. EVALUATING EFFECTIVENESS OF LASER PHOTOCOAGULATION AND INTRAVITREAL ANTI-VEGF INJECTIONS IN STAGE III RETINOPATHY OF PREMATURITY. International Journal of Retina, [S.l.], v. 7, n. 2, p. 110, sep. 2024. ISSN 2614-8536. Available at: <https://ijretina.com/index.php/ijretina/article/view/286>. Date accessed: 28 sep. 2024. doi: https://doi.org/10.35479/ijretina.2024.vol007.iss002.286.
Section
Research Articles

References

1. Kim SJ, Port AD, Swan R, Campbell JP, Chan RVP, Chiang MF. Retinopathy of prematurity: a review of risk factors and their clinical significance. Surv Ophthalmol. 2018 Sep-Oct;63(5):618-637. doi: 10.1016/j.survophthal.2018.04.002. Epub 2018 Apr 19.
2. Gilbert C, Foster A. Childhood blindness in the context of VISION 2020 - The right to sight. Bull World Health Organ. 2001; 79(3):227–32.
3. Le C, Basani L, Zurakowski D, Ayyala R, Agraharam S. Retinopathy of prematurity: Incidence, prevalence, risk factors, and outcomes at a tertiary care center in Telangana. Journal of Clinical Ophthalmology and Research. 2016; 4(3):119.
4. Sen P, Jain S, Bhende P. Stage 5 retinopathy of prematurity: An update. Taiwan J Ophthalmol. 2018; 8(4):205–15.
5. Aaberg T, Ben-Sira I, Charles S, Clarkson J, Cohen BZ, Flynn J, Foos R, Garner A, Hirose T, Koerner F, Machemer R. An international classification of retinopathy of prematurity: II. The classification of retinal detachment. Archives of ophthalmology. 1987 Jul 1;105(7):906-12.
6. Good W V., Flynn JT, Flach AJ, Cibis GW, Raab EL, Beauchamp GR. Final results of the Early Treatment for Retinopathy of Prematurity (ETROP) randomized trial. Trans Am Ophthalmol Soc. 2004; 102:233–50.
7. Hwang CK, Hubbard GB, Hutchinson AK, Lambert SR. Outcomes after Intravitreal Bevacizumab versus Laser Photocoagulation for Retinopathy of Prematurity: A 5-Year Retrospective Analysis. Ophthalmology. 2015 May; 122(5):1008–15.
8. Isaac M, Mireskandari K, Tehrani N. Treatment of type 1 retinopathy of prematurity with bevacizumab versus laser. J AAPOS. 2015 Apr; 19(2):140–4.
9. Gunay M, Sukgen EA, Celik G, Kocluk Y. Comparison of Bevacizumab, Ranibizumab, and Laser Photocoagulation in the Treatment of Retinopathy of Prematurity in Turkey. Curr Eye Res. 2017 Mar; 42(3):462–9.
10. Chandra P, Chawla D, Deorari AK, Dogra MR, Jalali S, Kumar P, et al. Screening and Management of Retinopathy of Prematurity. Journal of Neonatology. 2020; 34(1–2):63–82.
11. Wang SD, Zhang G. Laser therapy versus intravitreal injection of anti VEGF agents in monotherapy of ROP: a Meta-analysis. Int J Ophthalmol. 2020; 13(5):806–15.
12. Mintz-Hittner HA, Kennedy KA, Chuang AZ. Efficacy of intravitreal bevacizumab for stage 3+ retinopathy of prematurity. N Engl J Med. 2011 Feb; 364(7):603–15.
13. Kang HG, Choi EY, Byeon SH, Kim SS, Koh HJ, Lee SC, et al. Intravitreal ranibizumab versus laser photocoagulation for retinopathy of prematurity: efficacy, anatomical outcomes, and safety. Br J Ophthalmol. 2019 Sep; 103(9):1332–6.
14. O’Keeffe N, Murphy J, O’Keefe M, Lanigan B. Bevacizumab compared with diode laser in stage 3 posterior retinopathy of prematurity: A 5 year follow up. Ir Med J. 2016 Feb; 109(2):355.
15. Snyder LL, Garcia-Gonzalez JM, Shapiro MJ, Blair MP. Very Late Reactivation of Retinopathy of Prematurity after Monotherapy with Intravitreal Bevacizumab. Ophthalmic Surg Lasers Imaging Retina. 2016 Mar; 47(3):280–3.
16. Hu J, Blair MP, Shapiro MJ, Lichtenstein SJ, Galasso JM, Kapur R. Reactivation of retinopathy of prematurity after bevacizumab injection. Arch Ophthalmol. 2012 Aug; 130 (8):1000–6.
17. Hajrasouliha AR, Garcia-Gonzales JM, Shapiro MJ, Yoon H, Blair MP. Reactivation of Retinopathy of Prematurity Three Years after Treatment with Bevacizumab. Ophthalmic Surg Lasers Imaging Retina. 2017 Mar; 48 (3):255–9.
18. Aldebasi T, Guma MA, Bashir R, Al Saif S, Altwaijri WA, Al Bekairy AM. Intravitreal Ranibizumab Injection for the Treatment of Retinopathy of Prematurity. Med Princ Pract. 2019; 28 (6):526–32.
19. Chen SN, Lian I, Hwang YC, Chen YH, Chang YC, Lee KH, et al. Intravitreal anti-vascular endothelial growth factor treatment for retinopathy of prematurity: comparison between Ranibizumab and Bevacizumab. Retina. 2015 Apr; 35 (4):667–74.