Vascular development analysis: a study for tertiary anti-vascular endothelial growth factor therapy after second reactivation of retinopathy of prematurity

作者：Xuerui Zhang, Jie Peng, Yuan Yang, Y Y Liu, Wenting Zhang, Victoria Y. Gu, Huanyu Liu, Haodong Xiao, Jiawei Yin, Yu Xu, Peiquan Zhao · 发表于：Frontiers in Medicine · 年份：2024 · DOI：10.3389/fmed.2024.1421894 · 被引用次数：5 · 研究领域：Retinopathy of Prematurity Studies、Kawasaki Disease and Coronary Complications、Neonatal Respiratory Health Research

Purpose To observe the vascular development results of tertiary anti-vascular endothelial growth factor (anti-VEGF) therapy following spontaneous second reactivation of retinopathy of prematurity (ROP). Methods This retrospective study included 22 infants (42 eyes) with Type 1 or aggressive ROP (A-ROP) who received three anti-VEGF drug treatments for ROP from January 2018 to December 2022. The vascular growth, possible associated risk factors, and the retinal vascularization (DB/DF ratio) were assessed. Results The mean follow-up was 17.6 months. After the 3 rd intravitreal injection, seven eyes showed complete vascularization (Group 1), while the remaining 35 eyes demonstrated persistent avascular retina (PAR) (Group 2). In Group 2, 17 eyes maintained a stable state and were classified in the regression subgroup. The other 18 eyes developed a 3 rd reactivation (reactivation subgroup) and were treated with laser photocoagulation (LPC). Birth weight (BW) was significantly lower in Group 2 than in Group 1 ( p < 0.001). The decision tree analysis shows that only infants weighing more than 1,250 g (17.50%) had a chance to achieve complete retinal vascularization. The possibility of PAR was higher in patients with BW <1,250 g than ≥1,250 g (70.00% vs. 12.50%). In addition, most infants with BW ≥ 1,290 g and initial ROP disease in Zone I or posterior Zone II developed PAR. Conclusion Tertiary IVR can successfully treat a second ROP reactivation and improve peripheral ...