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Intravitreal ranibizumab versus laser photocoagulation for retinopathy of prematurity: efficacy, anatomical outcomes and safety
  1. Hyun Goo Kang1,
  2. Eun Young Choi1,
  3. Suk Ho Byeon2,
  4. Sung Soo Kim2,
  5. Hyoung Jun Koh2,
  6. Sung Chul Lee2,
  7. Min Kim1
  1. 1 Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
  2. 2 Department of Ophthalmology, Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
  1. Correspondence to Dr Min Kim, Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea; minkim76{at}gmail.com

Abstract

Background/Aims To compare the efficacy, anatomical outcomes and complications of intravitreal ranibizumab with those of laser photocoagulation for retinopathy of prematurity (ROP).

Methods This is a retrospective case series of 314 eyes from 165 infants diagnosed with type I ROP and treated with either laser photocoagulation (161 eyes) or intravitreal ranibizumab (0.25 mg/0.025 mL) injection (153 eyes) between January 2006 and December 2016 in a tertiary referral-based hospital. The main outcome was the rate of recurrence requiring additional treatment. Secondary outcomes included the incidence of major complications and final refractive error.

Results The mean follow-up was 36.3±31.9 months. Recurrences requiring further intervention were noted in 22 (13.7%) laser-treated and 15 (9.8%) ranibizumab-treated eyes (p=0.196). Retinal detachment (8 vs 1, p=0.037) and macular dragging (7 vs 1, p=0.039) were observed in the laser-treated and injection-treated groups, respectively, but no systemic or neurodevelopmental adverse events were reported. In the ranibizumab group, 95.6% showed fully vascularised retinas. Multivariate analyses revealed that birth weight (OR 0.993, p=0.023) and higher ROP stage (OR 11.222, p=0.008) influenced the incidence of major complications.

Conclusion Intravitreal ranibizumab for ROP appears to achieve similar therapeutic effects than did laser photocoagulation, but with fewer surgical complications such as retinal detachment or macular dragging.

  • child health (paediatrics)
  • neovascularisation
  • retina
  • treatment lasers

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Footnotes

  • Contributors Conception or design of the work: HGK, SCL and MK. Data collection: HGK, SHB, SSK, HJK, SCL and MK. Data analysis and interpretation: HGK and EYC. Drafting the article: HGK and MK. Critical revision of the article: HGK and MK. Final approval of the version to be published: HGK, EYC, SHB, SSK, HJK, SCL and MK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Ethics approval Ethics approval was obtained from Gangnam Severance Hospital Institutional Review Board (IRB)/Ethics Committee. The study adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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