Prospective clinical study of two different treatment regimens of combined laser photocoagulation and intravitreal bevacizumab for retinopathy of prematurity: the Indian Twin Cities ROP Study (ITCROPS) database report number 9.

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.