Sahinoglu-Keskek N, Akkoyun I, Torer B, Cetinkaya B, Gülcan H, Yilmaz G, Oto S
Department of Ophthalmology, Baskent University Faculty of Medicine, Dadaloglu district, 2591, street, 4/A, Adana, 01250 Yuregir, Turkey.
Department of Ophthalmology, Baskent University Faculty of Medicine, Dadaloglu district, 2591, street, 4/A, Adana, 01250 Yuregir, Turkey; Department of Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey.
J Fr Ophtalmol. 2025 Jan;48(1):104348. doi: 10.1016/j.jfo.2024.104348. Epub 2024 Nov 6.
Anti-VEGF agents are used in the treatment of aggressive retinopathy of prematurity (A-ROP), which is a rapidly progressive form of retinopathy of prematurity (ROP). This study aimed to evaluate risk factors for the early reactivation after anti-VEGF therapy with intravitreal ranibizumab (IVR) injection.
Consecutive cases of A-ROP were included in this retrospective study. Intravitreal ranibizumab (0.25mg, Lucentis, Novartis AG) was injected in all A-ROP cases as initial therapy. Probable risk factors were reviewed. A reactivation in 4 weeks or less was defined as "early", and greater than 4 weeks was defined as "late". Since reactivations were observed in Zone II in all cases, laser photocoagulation (LP) was performed as rescue therapy.
The study consisted of 16 patients with A-ROP, all of whom experienced reactivation. In 6 cases,reactivation was seen early (Group-E), and in 10 cases, reactivation was late (Group-L). The mean gestational age of Group-E and Group-L were 26.60 (±0.89) and 26.73 (±2.10) weeks respectively (P=0.9), and mean birth weights were 918 (±282) and 898 (±0188) grams respectively (P=0.8). Zone I ROP was seen at a higher rate in Group-E (83.3%) than Group-L (30%) (P=0.009). Total O treatment duration in Group-E was statistically significantly longer than Group-L (P=0.03). The mean value of platelet distribution width (PDW) in Group-E was statistically significantly higher (P=0.002).
In patients with A-ROP, extended duration of O therapy and high values of PDW might be factors predictive of early reactivation after intravitreal ranibizumab injection.
抗血管内皮生长因子（VEGF）药物用于治疗侵袭性早产儿视网膜病变（A-ROP），这是一种快速进展型的早产儿视网膜病变（ROP）。本研究旨在评估玻璃体内注射雷珠单抗（IVR）进行抗VEGF治疗后早期复发的危险因素。
本回顾性研究纳入了连续的A-ROP病例。所有A-ROP病例均接受玻璃体内注射雷珠单抗（0.25mg，Lucentis，诺华公司）作为初始治疗。对可能的危险因素进行了回顾。4周及以内的复发定义为“早期”，超过4周的复发定义为“晚期”。由于所有病例均在II区观察到复发，因此进行激光光凝（LP）作为挽救治疗。
本研究包括16例A-ROP患者，所有患者均出现复发。6例患者复发较早（E组），10例患者复发较晚（L组）。E组和L组的平均胎龄分别为26.60（±0.89）周和26.73（±2.10）周（P = 0.9），平均出生体重分别为918（±282）克和898（±188）克（P = 0.8）。E组I区ROP的发生率（83.3%）高于L组（30%）（P = 0.009）。E组的总氧疗持续时间在统计学上显著长于L组（P = 0.03）。E组血小板分布宽度（PDW）的平均值在统计学上显著更高（P = 0.002）。
在A-ROP患者中，氧疗时间延长和PDW值高可能是玻璃体内注射雷珠单抗后早期复发的预测因素。
