Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; Bascom Palmer Eye Institute, University of Miami Leonard M. Miller School of Medicine, Miami, Florida; Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois.
Ophthalmology. 2023 Apr;130(4):373-378. doi: 10.1016/j.ophtha.2022.11.012. Epub 2022 Nov 15.
To compare the types and dosages of anti-vascular endothelial growth factors (VEGFs) to ascertain whether specific dosages or types of injection were associated with retreatment in clinical practice in the United States.
Multicenter, retrospective, consecutive series.
Patients with retinopathy of prematurity (ROP) treated with anti-VEGF injections from 2007 to 2021.
Sixteen sites from the United States participated. Data collected included demographics, birth characteristics, examination findings, type and dose of anti-VEGF treatment, retreatment rates, and time to retreatment. Comparisons of retreatment rates between bevacizumab and ranibizumab intravitreal injections were made.
Relative rate of retreatment between varying types of anti-VEGF therapy, including bevacizumab and ranibizumab, and the various dosages used for each.
Data from 873 eyes of 661 patients (61% male and 39% female) were collected. After exclusion of 40 eyes treated with laser before anti-VEGF injection and 266 eyes re-treated with laser at or beyond 8 weeks after the initial anti-VEGF treatment, 567 eyes of 307 patients (63% male and 37% female) remained and were included in the primary analysis. There was no difference between the no retreatment and retreatment groups in terms of birthweight, gestational age, age at first injection, ROP stages, or number of involved clock hours. The retreatment group had a larger percentage of aggressive ROP (34% vs. 18%, P < 0.001) and greater percentage of zone 1 ROP (49 vs. 34%, P = 0.001) than the no retreatment group. Ranibizumab use was associated with a higher rate of retreatment than bevacizumab use (58% vs. 37%, P < 0.001), whereas the rate of retreatment was not associated with a specific dose of ranibizumab (R2 = 0.67, P = 0.32). Meanwhile, lower doses of bevacizumab were associated with higher rates of retreatment compared with the higher doses (R2 = 0.84, P = 0.01). There was a dose-specific trend with higher doses trending toward lower retreatments for bevacizumab.
In a multicenter study of ROP patients initially treated with anti-VEGF therapy, ranibizumab and lower-dose bevacizumab use were associated with an increased rate of retreatment when compared with higher-dose bevacizumab.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
比较抗血管内皮生长因子（VEGF）的类型和剂量，以确定在美国的临床实践中，特定剂量或类型的注射是否与再治疗相关。
多中心、回顾性、连续系列研究。
2007 年至 2021 年间接受抗 VEGF 注射治疗的早产儿视网膜病变（ROP）患者。
来自美国的 16 个地点参与了研究。收集的数据包括人口统计学、出生特征、检查结果、抗 VEGF 治疗的类型和剂量、再治疗率以及再治疗时间。比较了贝伐单抗和雷珠单抗玻璃体内注射的再治疗率。
不同类型抗 VEGF 治疗（包括贝伐单抗和雷珠单抗）之间以及每种治疗方法的不同剂量之间再治疗率的相对比率。
共收集了 661 名患者 873 只眼的数据（61%为男性，39%为女性）。排除 40 只眼在接受抗 VEGF 注射前接受激光治疗和 266 只眼在初次抗 VEGF 治疗后 8 周或以上接受激光治疗后，307 名患者的 567 只眼（63%为男性，37%为女性）被纳入主要分析。在出生体重、胎龄、首次注射年龄、ROP 分期或受累时钟小时数方面，无再治疗组和再治疗组之间没有差异。再治疗组中侵袭性 ROP 的比例（34% vs. 18%，P < 0.001）和 1 区 ROP 的比例（49% vs. 34%，P = 0.001）均大于无再治疗组。与贝伐单抗相比，雷珠单抗的再治疗率更高（58% vs. 37%，P < 0.001），而雷珠单抗的再治疗率与特定剂量无关（R2 = 0.67，P = 0.32）。同时，与高剂量相比，低剂量的贝伐单抗与更高的再治疗率相关（R2 = 0.84，P = 0.01）。贝伐单抗存在剂量特异性趋势，较高剂量的贝伐单抗趋向于较低的再治疗率。
在一项对最初接受抗 VEGF 治疗的 ROP 患者的多中心研究中，与高剂量贝伐单抗相比，雷珠单抗和低剂量贝伐单抗的使用与更高的再治疗率相关。
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