PROGRESSIVE RETINAL DETACHMENT IN INFANTS WITH RETINOPATHY OF PREMATURITY TREATED WITH INTRAVITREAL BEVACIZUMAB OR RANIBIZUMAB.

Abstract

PURPOSE:

Fibrovascular contraction and tractional retinal detachment (TRD) are recognized complications associated with the use of anti-vascular endothelial growth factor agents in vasoproliferative vitreoretinopathies. The authors characterize TRDs that developed after intravitreal bevacizumab or ranibizumab therapy for vascularly active retinopathy of prematurity.

METHODS:

This is an international, multicenter, interventional, retrospective, case series. Thirty-five eyes from 23 infants were included. Inclusion required anti-vascular endothelial growth factor treatment of Type 1 retinopathy of prematurity with progression to TRD.

RESULTS:

Mean gestational age was 26 ± 2 weeks, and mean birth weight was 873 ± 341 g. Mean postmenstrual age on the day of injection was 35 ± 2 weeks. Retinal detachment was noted a mean of 70 days (median, 34; range, 4-335) after injection. Eleven percent detached within 1 week, 23% within 2 weeks, and 49% within 4 weeks. The highest stage of retinopathy of prematurity noted was 4A in 29%, 4B in 37%, and 5 in 34% of eyes. Time to RD negatively correlated with postmenstrual age at the time of injection (Rho = -0.54; P < 0.01). Three TRD configurations were observed: 1) conventional peripheral elevated ridge or volcano-shaped Stage 5 detachment, 2) midperipheral detachment with tight circumferential vectors, and 3) very posterior detachment with prepapillary contraction. Full or partial reattachment was achieved with surgical intervention in 86% of eyes.

CONCLUSION:

Progressive atypical TRD may occur after anti-vascular endothelial growth factor injections for retinopathy of prematurity. The configuration of the detachment varies with the extent of primary retinal vascularization present at the time of treatment.

• Authors: Yoshihiro Yonekawa, Wei-Chi Wu, Cristina E Nitulescu, R V Paul Chan, Aristomenis Thanos, Benjamin J Thomas, Bozho Todorich, Kimberly A Drenser, Michael T Trese, Antonio Capone Jr
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 38 Issue 6 Pg. 1079-1083 (Jun 2018) ISSN: 1539-2864 [Electronic] United States
• PMID: 28471890 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Angiogenesis Inhibitors
• Bevacizumab
• Ranibizumab

Topics

• Angiogenesis Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Bevacizumab (administration & dosage, adverse effects, therapeutic use)
• Female
• Humans
• Infant
• Infant, Newborn
• Intravitreal Injections
• Male
• Ranibizumab (administration & dosage, adverse effects, therapeutic use)
• Retinal Detachment (chemically induced)
• Retinopathy of Prematurity (drug therapy)
• Retrospective Studies