A comparison of laser photocoagulation and intravitreal bevacizumab for stage 3 retinopathy of prematurity

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Author:
YIN Hong(Department of Ophthalmology, Peoples' Hospital,Beijing University, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100044 ,China)
LI Xiao-xin(Department of Ophthalmology, Peoples' Hospital,Beijing University, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100044 ,China)
LIANG Jian-hong(Department of Ophthalmology, Peoples' Hospital,Beijing University, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100044 ,China)
Journal Title:
Chinese Journal of Ocular Fundus Diseases
Issue:
Volume 28, Issue 01, 2012
DOI:
10.3760/cma.j.issn.1005-1015.2012.01.005
Key Word:
Retinopathy of prematurity/surgery;Scleral buckling;Vitrectomy

Abstract: Objective To compare the efficacy and safety of laser photocoagulation and intravitreal injection of bevacizumab for stage 3 retinopathy of prematurity (ROP).Methods The study included 38eyes of 19 infants with stage 3 ROP (18 eyes of 9 infants in zone Ⅰ,20 eyes of 10 infants in zone Ⅱ ).All the patients were examined by indirect ophthalmoscope and photographed by wide-angle digital retinal imaging system (RetCam Ⅱ ). The fundus lesions in both eyes were the same. Patients received laser photocoagulation in one eye (laser group) and intravitreal injection of 0.03 ml bevacizumab (25 mg/ml) in the fellow eyes (bevacizumab group) during treatment.Follow-up ranged from 12 to 66 weeks,with an average of 33 weeks. The regression time of neovascular ridges and plus-diseases in two groups were compared.Results For 18 eyes with stage 3 ROP in zone Ⅰ,the regression time of neovascular ridges and plus-diseases were (2.25 ±0.46) and (2.11 ±0.60) weeks respectively in bevacizumab group,and both were (3.75 ± 1.75) weeks in laser group.The differences between those two groups were statistically significant (F=18.29,15.56;P<0.05).For 20 eyes with stage 3 ROP in zone Ⅱ,the regression time of neovascular ridges and plus-diseases were (3.1 ±1.72) and (2.1 ± 0.56) weeks respectively in bevacizumab group,and were (3.50± 1.90) and (2.50± 1.35) weeks respectively in laser group.The differences between those two groups were not statistically significant (F =0.38,2.62 ; P> 0.05).There were more fibrous membrane proliferations on the retinal surface in 8 eyes,including 6 eyes in laser group and 2 eyes in bevacizumab group. There was no treatment-related endophthalmitis,cataract,retinal tears and other complications during the follow-up.Conclusion The laser photocoagulation and intravitreal injection of bevacizumab were both safe and effective in treating stage 3 ROP.

  • [1]Lalwani GA,Berrocal AM,Murray TG,et al.Off-label use of intravitreal bevacizumab (Avastin) for salvage treatment in progressive threshold retinopathy of prematurity.Retina,2008,28(3 Suppl):13-18.
  • [2]单海冬,赵培泉,黄欣,等.经双目间接检眼镜激光光凝治疗严重早产儿视网膜病变.中华眼底病杂志,2008,24:13-16.
  • [3]Kychenthal A, Dorta P, Katz X.Zone Ⅰ retinopathy of prematurity:clinical characteristics and treatment outcomes.Retina,2006,26(7 Suppl):11-15.
  • [4]黄丽娜,吴政根,张国明,等.血管内皮生长因子基因多态性与早产儿视网膜病变预后的相关性研究.中华眼底病杂志,2008,24:45-47.
  • [5]Ferrara N,Hillan KJ,Novotny W. Bevacizumab (Avastin):a humanized anti-VEGF monoclonal antibody cancer thrapy.Biochem Biophys Res Commum,2005,333:328-335.
  • [6]Mintz-Hittner HA,Kuffel RR Jr.Intravitreal injection of bevacizumab (avastin) for treatment of stage 3 retinopathy of prematurity in zone Ⅰ or posterior zone Ⅱ.Retina,2008,28:831-838.
  • [7]The Committee for the Classification of Retinopathy of Prematurity.An international classification of retinopathy of prematurity.Arch Ophthalmol,1984,102:1130-1134.
  • [8]Good WV,Early Treatment for Retinopathy of Prematurity Cooperative Group.Final results of the Early Treatment for Retinopathy of Prematurity (ETROP) randomized trial.Trans Am Ophthalmol Soc,2004,102:233-248.
  • [9]Lynch SS, Cheng CM. Bevacizumab for neovascular ocular diseases.Ann Pharmacother,2007,41:614-625.
  • [10]Madan A. Angiogenesis and antiangiogenesis in the neonate:relevance to retinopathy of prematurity. Neoreviews,2003,4:356-364.
  • [11]Lashkari K,Hirose T,Yazdany J,et al.Vascular endothelial growth and hepatocyte growth factor levels are differentially elevated in patients with advanced retinopathy of prematurity.Am Pathol,2000,156:1337-1344.
  • [12]Hughes S,Yang H,Chan-ling T.Vascularization of the human fetal retina:roles of vasculogenesis and angiogenesis. Invest Ophthalmol Vis Sci,2000,41:1217-1228.
  • [13]尹虹,黎晓新,梁建宏,等.影响1区早产儿视网膜病变激光治疗结果的因素分析.中华眼底病杂志,2010,26:58-60.
  • [14]Kivlin JD,Biglan AW,Gordon RA,et al.Early retinal vessel development and iris vessel dilatation as factors in retinopathy of prematurity:cryotherapy for retinopathy of prematurity (CRYO-ROP) cooperative group.Arch Ophthalmol,1996,114:150-154.
  • [15]Flynn JT,Chan-Ling T.Retinopathy of prematurity:two distinct mechanisms that underlie zone 1 and zone 2 disease. Am J Ophthalmol,2006,142:46-59.
  • [16]Hartnett ME,McColm JR. Fibrovascular organization in the vitreous following laser for ROP:implications for prognosis.Retina,2006,26:24-31.
  • [17]Mintz-Hittner HA,Best LM.Antivascular endothelial growth factor for retinopathy of prematurity.Curr OpinPediatr,2009,21:182-187.
  • [18]Ishida S,Usui T, Yamashiro K,et al.VEGF 164-mediated inflammation is required for pathological,but not physiological,ischemia-induced retinal neovascularization.J Exp Med,2003,198:483-489.
  • [19]Honda S, Hirabayashi H, Tsukahara Y, et al. Acute contraction of the proliferative membrance after an intravitreal injection of bevacizumab for advanced retinopathy of prematurity.Graefes Arch Clin Exp Ophthalmol,2008,246:1061-1063.
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