Belenje Akash, Reddy Rakasi Ugandhar, Padhi Tapas Ranjan, Jalali Subhadra
Srimati Kanuri Santhamma Center for Vitreo Retinal Diseases, Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Vitreoretinal and Uveitis Services, Anant Bajaj Retina Institute, Mithu Tulsi Chanrai Campus, L V Prasad Eye Institute, Bhubaneswar, India.
Eye (Lond). 2025 Jul 11. doi: 10.1038/s41433-025-03896-x.
Utility, safety, and feasibility study of office-based Non-contact Ultra widefield Oral Fundus Fluorescein Dye Angiography (NC-UWF-OFDA) to assess disease reactivation in babies treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) for Aggressive Retinopathy of Prematurity (A-ROP).
Eyes clinically suspected to have a possible or definite reactivation after anti-VEGF injection were included in this pilot study. NC-UWF-OFDA was performed in the office setting. Imaging was done prospectively in preterm babies with A-ROP injected with anti-VEGF. OFDA images were analysed for signs of reactivation.
A total of 20 eyes of 10 preterm babies treated with anti-VEGF underwent NC-UWF-OFDA imaging. The OFDA images were analysed to assess the pattern and dynamics of retinal vasculature with a special focus on detecting the active new vessels through leakage, the pattern of vasculature at the vascular avascular (V-Av) junction, and delineation of the persistent avascular retina (PAR). Seven eyes were confirmed with reactivation of ROP requiring treatment while the rest were followed up. None of the subjects had dye or procedure-related systemic adverse events.
NC-UWF-OFDA is safe and effective in the diagnosis of reactivation of ROP following anti-VEGF injections. A better appreciation of retinal vascular dynamics with accurate delineation of the posterior extent of capillary non-perfusion areas, PAR, and early definitive detection of active neovascularization helped in formulating the extent of laser treatment needed including intraoperatively. This helped us avoid unnecessary parenteral injections/general anaesthesia for evaluation of disease reactivation and helped avoid over-treatment of cases having clinical suspicion of reactivation during fundoscopy.
基于办公室的非接触式超广角眼底荧光素血管造影（NC-UWF-OFDA）评估玻璃体内注射抗血管内皮生长因子（抗VEGF）治疗早产儿侵袭性视网膜病变（A-ROP）后疾病再激活的实用性、安全性和可行性研究。
本前瞻性研究纳入了抗VEGF注射后临床怀疑可能或确定有再激活的眼睛。在办公室环境中进行NC-UWF-OFDA检查。对接受抗VEGF注射的A-ROP早产儿进行前瞻性成像。分析OFDA图像以寻找再激活的迹象。
共有10例接受抗VEGF治疗早产儿的20只眼睛进行了NC-UWF-OFDA成像。分析OFDA图像以评估视网膜血管系统的模式和动态，特别关注通过渗漏检测活跃的新生血管、血管无血管（V-Av）交界处的血管模式以及持续性无血管视网膜（PAR）的描绘。7只眼睛被证实ROP再激活需要治疗，其余眼睛进行随访。所有受试者均未发生染料或与检查相关的全身性不良事件。
NC-UWF-OFDA在诊断抗VEGF注射后ROP再激活方面安全有效。更好地了解视网膜血管动力学，准确描绘毛细血管无灌注区的后部范围、PAR，并早期明确检测活跃的新生血管，有助于制定所需的激光治疗范围，包括术中治疗范围。这有助于我们避免为评估疾病再激活而进行不必要的肠胃外注射/全身麻醉，并有助于避免在眼底镜检查时对临床怀疑再激活的病例进行过度治疗。
