Departments of Ophthalmology, and.
Pediatrics, Kindai University Faculty of Medicine, Osaka, Japan.
Retina. 2021 Nov 1;41(11):2261-2268. doi: 10.1097/IAE.0000000000003196.
To investigate the efficacy and risk factors of intravitreal antivascular endothelial growth factor injection (anti-VEGF therapy) for retinopathy of prematurity (ROP).
We retrospectively reviewed 80 consecutive eyes of 43 patients with Type 1 ROP or worse who received anti-VEGF therapy during January 2012-February 2018. Patients were divided into those who were injected with 0.25 mg of bevacizumab (IVB group, 37 eyes) and 0.25 mg of ranibizumab (IVR group, 43 eyes). Serum VEGF concentrations of 18 patients were measured before and after IVR.
Antivascular endothelial growth factor injection therapy reduced ROP activity in all eyes; however, 14 eyes (17.5%) exhibited reactivation. The reactivation rates of the IVB and IVR groups were 13.5% and 20.9%, respectively (P = 0.556). Multivariate logistic regression analysis showed that postmenstrual age ≤35 weeks at anti-VEGF therapy (P = 0.014) and aggressive posterior ROP (P = 0.044) was significantly associated with reactivation. Serum VEGF was significantly suppressed at Days 1 (P < 0.001) and 7 (P = 0.012) after IVR and returned to the preinjection level by Day 14 (P = 0.210).
Both IVR and IVB seemed effective in reducing ROP activity. Reactivation after anti-VEGF therapy may be associated with younger postmenstrual age at anti-VEGF therapy and aggressive posterior ROP.
研究玻璃体内抗血管内皮生长因子注射(抗 VEGF 治疗)治疗早产儿视网膜病变(ROP)的疗效和风险因素。
我们回顾性分析了 2012 年 1 月至 2018 年 2 月期间接受抗 VEGF 治疗的 43 例 1 型或更严重 ROP 患者的 80 只连续眼。患者分为接受 0.25mg 贝伐单抗(IVB 组,37 只眼)和 0.25mg 雷珠单抗(IVR 组,43 只眼)治疗的患者。测量了 18 例患者 IVR 前后的血清 VEGF 浓度。
抗血管内皮生长因子注射治疗使所有眼睛的 ROP 活动均减少,但 14 只眼睛(17.5%)出现再激活。IVB 和 IVR 组的再激活率分别为 13.5%和 20.9%(P=0.556)。多因素逻辑回归分析显示,抗 VEGF 治疗时的校正后孕周≤35 周(P=0.014)和侵袭性后部 ROP(P=0.044)与再激活显著相关。IVR 后第 1 天(P<0.001)和第 7 天(P=0.012)血清 VEGF 显著降低,第 14 天(P=0.210)恢复至注射前水平。
IVR 和 IVB 似乎都能有效降低 ROP 活动。抗 VEGF 治疗后的再激活可能与抗 VEGF 治疗时的校正后孕周较小和侵袭性后部 ROP 有关。