Byers Eye Institute, Horngren Family Vitreoretinal Center, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA.
Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI, USA.
Eur J Ophthalmol. 2021 Jul;31(4):2135-2140. doi: 10.1177/1120672120945101. Epub 2020 Jul 28.
To determine if fluorescein angiographic (FA) findings after intravitreal ranibizumab (IVR) for retinopathy of prematurity (ROP) conform to a class effect previously described with bevacizumab.
Single-center retrospective case series of all infants treated with 0.2 mg (0.02 mL) IVR for Type 1 ROP from July 2016 to November 2018. FA were obtained at 40, 52, 62, and 72 weeks of postmenstrual age (PMA) using wide-angle photography. FA images were analyzed and the peripheral avascular areas measured with ImageJ using a reference disc diameter (DD). Based on the extent of the avascular area and tortuosity of the retinal vessels all eyes were classified into four categories: complete vascular maturity (vascularization within 2 DD of the ora serrata), VAA (avascular area >2 DD of the ora serrata), VAT (avascular area >2 DD of the ora serrata and posterior tortuosity), and reactivation (recurrence of stage disease).
About 13 infants were enrolled and 24 eyes were available in this study. None of the eyes reached complete vascular maturity at an average PMA of 60 weeks, 7 (29%) eyes presented with VAA, 8 (33%) with VAT, and 9 (37.5%) reactivated. The reactivated eyes presented with the largest area of peripheral ischemia, followed by the VAT and then the VAA groups ( = 0.02).
IVR conforms to the previously described regression patterns following intravitreal bevacizumab for ROP indicative of a class effect. Follow-up using FA might help to optimize the management of these infants after injection of the drug.
确定玻璃体内雷珠单抗（IVR）治疗早产儿视网膜病变（ROP）后的荧光素血管造影（FA）结果是否符合贝伐单抗先前描述的类效应。
这是一项 2016 年 7 月至 2018 年 11 月在单中心进行的回顾性病例系列研究，纳入了所有接受 0.2mg（0.02ml）IVR 治疗 1 型 ROP 的婴儿。使用广角摄影术在 40、52、62 和 72 周的校正胎龄（PMA）时获得 FA。使用 ImageJ 通过参考视盘直径（DD）分析 FA 图像并测量周边无血管区。根据无血管区的范围和视网膜血管的迂曲程度，所有眼睛分为以下四类：完全血管成熟（视盘锯齿缘 2DD 范围内血管化）、VAA（无血管区>视盘锯齿缘 2DD）、VAT（无血管区>视盘锯齿缘 2DD 且后部迂曲）和再激活（疾病复发）。
这项研究纳入了约 13 名婴儿，共有 24 只眼。在平均 PMA 为 60 周时，没有一只眼睛达到完全血管成熟，7（29%）只眼出现 VAA，8（33%）只眼出现 VAT，9（37.5%）只眼再激活。再激活的眼睛表现出最大的周边缺血区，其次是 VAT 组，然后是 VAA 组（ = 0.02）。
IVR 符合先前描述的玻璃体内贝伐单抗治疗 ROP 后回归模式，表明存在类效应。FA 随访可能有助于优化药物注射后这些婴儿的管理。
