Original Scientific Articles

Neonatal risk factors for the development of aggressive retinopathy of prematurity (A-ROP) and anti-VEGF treatment outcomes

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Abstract

Introduction. Retinopathy of prematurity (ROP) is a neurovascular disease that, if left untreated, leads to severe visual impairment and blindness. Early diagnosis and timely therapy reduce the risk of a severe 
outcome. The most significant risk factors for the development of the disease are low gestational age, low birth weight, development of respiratory distress and prolonged need for oxygen therapy, neonatal sepsis, anaemia, and others. This paper analyses the most significant risk factors and the outcome of treatment with anti-VEGF therapy, as well as the additional need for laser photocoagulation.
Methods. A retrospective study was conducted involving 30 children (60 eyes) with the A-ROP form of retinopathy, divided into two groups according to the anti-VEGF agent administered (bevacizumab or ranibizumab).
Results. Regarding gestational age, a statistically significant difference was found between the two groups. Birth weight was higher in the group that received intravitreal bevacizumab (IVB). Readministration of the 
drug was required in three patients (five eyes) treated with bevacizumab, and in four patients (nine eyes) who received ranibizumab (IVR). The need for laser photocoagulation was 40% in the IVB group versus 100% in the IVR group, a statistically highly significant difference.
Conclusion. Timely diagnosis and adequate therapy significantly improve outcomes and reduce the risk of severe visual impairment. In this study, bevacizumab showed superiority over ranibizumab with respect to the effect on ROP reactivation and the need for additional laser intervention.

Keywords: ROP, retinopathy of prematurity, anti-VEGF, bevacizumab, ranibizumab

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